OrganizationActive
Elite Medical Clinic, LLC
NPI 1407505142 · Multi-Specialty Clinic/Center · Douglas, GA
Provider details
- NPI number
- 1407505142
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Teresa Wilson, Owner(912) 393-5120
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1204 Ocilla Rd
Douglas, GA 31533-2220
Phone: (912) 393-5120
Approximate (ZIP-level) locationGet directions
Mailing address
1204 Ocilla Rd
Douglas, GA 31533-2220
Registry dates
- Enumerated
- 2022-03-21
- Last updated
- 2022-03-21
- Certified
- 2022-03-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.