Provider profile · NPI 1861915647

316 Family Medicine

Family Medicine · Bremen, GA · NPI 1861915647 · No federal exclusion match

✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 21, 2026. Source-linked, daily-refreshed. Public data only — no PHI.

Registry details

Type

Organization

Primary specialty

Family Medicine

Enumerated

Jul 24, 2017

License(s)

059986 (GA)

Addresses on file

PurposeAddressCity/StatePhone
LOCATION222 GORDON ST Bremen, GA 30110-1519770-537-1234
MAILINGPO BOX 728 Bremen, GA 30110-0728770-537-1234

View on NPPES registry ↗

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