Provider Demographics
NPI:1346588324
Name:PARTNERS IN HEALTH LLC
Entity Type:Organization
Organization Name:PARTNERS IN HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:912-264-6303
Mailing Address - Street 1:118 NORTHPARK DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-2111
Mailing Address - Country:US
Mailing Address - Phone:912-268-4994
Mailing Address - Fax:912-434-9096
Practice Address - Street 1:118 NORTHPARK DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-2111
Practice Address - Country:US
Practice Address - Phone:912-268-4994
Practice Address - Fax:912-434-9096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA064606207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003134432AMedicaid