Gwendolyn Moddrell Md Pc in Swainsboro - Prescribing (medical)
Gwendolyn Moddrell Md Pc - NPI 1992911234
Gwendolyn Moddrell Md Pc is a Prescribing (medical) in Swainsboro, Georgia. Gwendolyn Moddrell Md Pc practices all healthcare services and medical treatments related to Prescribing (medical). The NPI Number for Gwendolyn Moddrell Md Pc is 1992911234. The last update date is 2008-08-12.
Gwendolyn Moddrell Md Pc's current location address is 247 W Main St # B, Swainsboro, Georgia. You can contact this provider via phone number 4782378101 and fax number 4782378118. The mailing address for Gwendolyn Moddrell Md Pc is 247 W Main St # B, Swainsboro, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Gwendolyn Moddrell Md Pc |
|---|---|
| Address | 247 W Main St # B, Swainsboro, Georgia |
| Phone Number | 4782378101 |
| Fax Number | 4782378118 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Moddrell Gwendolyn |
| Credentials | MD |
| Telephone Number | 4782378101 |
NPI Number Detail
| NPI Number | 1992911234 |
|---|---|
| Provider Enumeration Date | 2007-05-15 |
| Last Updated Date | 2008-08-12 |
Provider Mailing Address Detail
| Address | 247 W Main St # B |
|---|---|
| City | Swainsboro |
| State | Georgia (GA) |
| Post Code | 304013163 |
| Phone Number | 4782378101 |
| Fax Number | 4782378118 |
Provider's Primary Taxonomy Detail
| Speciality | Prescribing (medical) |
|---|---|
| Taxonomy | 103Tp0016X |
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Definition: A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establis |
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What is the Gwendolyn Moddrell Md Pc's 1992911234?
The Gwendolyn Moddrell Md Pc's NPI (National Provider Identifier) Number is 1992911234. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Gwendolyn Moddrell Md Pc is located?
The Gwendolyn Moddrell Md Pc is situated at the following address: 247 W Main St # B, Swainsboro, GA, 304013163.
What is Gwendolyn Moddrell Md Pc's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Gwendolyn Moddrell Md Pc is Prescribing (medical), and the corresponding taxonomy classification code for this specialized field is 103Tp0016X.
On what date did the Centers for Medicare & Medicaid Services issue the 1992911234 to Gwendolyn Moddrell Md Pc?
The Gwendolyn Moddrell Md Pc received its 1992911234 assignment from the Centers for Medicare & Medicaid Services on 2007-05-15.
When was the information pertaining to Gwendolyn Moddrell Md Pc most recently updated or revised?
The details related to Gwendolyn Moddrell Md Pc, including its address, specialty, and other relevant information, were last updated or revised on 2008-08-12.
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