Provider Demographics
NPI:1417042391
Name:GORDON COUNTY BOARD OF HEALTH
Entity type:Organization
Organization Name:GORDON COUNTY BOARD OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:VOCCIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-295-6704
Mailing Address - Street 1:310 N RIVER ST NW
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-9408
Mailing Address - Country:US
Mailing Address - Phone:706-624-1444
Mailing Address - Fax:706-624-1450
Practice Address - Street 1:310 N RIVER ST NW
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-9408
Practice Address - Country:US
Practice Address - Phone:706-624-1444
Practice Address - Fax:706-624-1450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025271251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000248091AMedicaid
GA600000745OtherPALMETTO GBA RR MEDICARE
GA10076442OtherAMERIGROUP, CMO
GA340939OtherWELLCARE, CMO
GA000051829GMedicaid
GA000457751GMedicaid
GA000619605GMedicaid
GA140294OtherPEACH STATE, CMO
GA000452955GMedicaid
GA000699223AMedicaid