Provider Demographics
NPI:1386903649
Name:SOUTH GEORGIA EMERGENCY MEDICINE ASSOCIATES PC
Entity type:Organization
Organization Name:SOUTH GEORGIA EMERGENCY MEDICINE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:CONNELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:229-224-1207
Mailing Address - Street 1:202 N CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-5123
Mailing Address - Country:US
Mailing Address - Phone:229-290-7459
Mailing Address - Fax:
Practice Address - Street 1:915 GORDON AVE
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-6614
Practice Address - Country:US
Practice Address - Phone:229-228-2000
Practice Address - Fax:386-274-7801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-08
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty