Provider Demographics
NPI:1578657821
Name:OCONEE FAMILY MEDICINE CENTER, PC
Entity Type:Organization
Organization Name:OCONEE FAMILY MEDICINE CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-453-9346
Mailing Address - Street 1:800 W THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-2674
Mailing Address - Country:US
Mailing Address - Phone:478-453-9346
Mailing Address - Fax:478-453-0205
Practice Address - Street 1:800 W THOMAS ST
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-2674
Practice Address - Country:US
Practice Address - Phone:478-453-9346
Practice Address - Fax:478-453-0205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty