Provider Demographics
NPI:1760046593
Name:PATIENT 1ST HEALTH & WELLNESS ASSOCIATES, LLC
Entity Type:Organization
Organization Name:PATIENT 1ST HEALTH & WELLNESS ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:E
Authorized Official - Last Name:PICKENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-482-6004
Mailing Address - Street 1:15125 U.S. HWY 19 S PMB 380
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792
Mailing Address - Country:US
Mailing Address - Phone:229-236-6601
Mailing Address - Fax:229-236-6602
Practice Address - Street 1:504 GORDON AVE
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-6646
Practice Address - Country:US
Practice Address - Phone:229-236-6601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-26
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty