Medfast 2
Legal Medicine (M.D./D.O.) Physician in Waycross, GA(View on Map)
Legal Business Name
Medfast 2
NPI Number
1003857517
NPI Type
Organization
Enumeration Date
06/08/2006
Specialties
(Taxonomies)Licenses
State
Georgia
License Number
031778
Contact
Information
Purpose
Mailing
Location
Address
1405 ALICE ST
1405 ALICE ST
City
Waycross
Waycross
State
GA
GA
Postal Code
31501-4528
31501-4528
Country
US
US
Telephone Number
(912) 285-3157
(912) 285-3157
Authorized Official
Name
Gerardo Klug
Title or Position
PRESIDENT
Telephone Number
(912) 285-3157
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/22/2020