Provider Demographics
NPI:1073683603
Name:CLAYTON COUNTY BOARD OF COMMISSIONERS
Entity Type:Organization
Organization Name:CLAYTON COUNTY BOARD OF COMMISSIONERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF BOARD OF COMMISSIONERS
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:E
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-472-8122
Mailing Address - Street 1:112 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-3539
Mailing Address - Country:US
Mailing Address - Phone:770-472-8149
Mailing Address - Fax:770-472-8014
Practice Address - Street 1:112 SMITH ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-3539
Practice Address - Country:US
Practice Address - Phone:770-472-8149
Practice Address - Fax:770-472-8014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031-023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000080484AMedicaid
GA590603969OtherRAILROAD MEDICARE
GA000080484AMedicaid