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SOUTHEAST GEORGIA PRIMARY CARE
NPI 1053429688
Family Medicine in Waycross, GA

Active since August 25, 2006
409 UVALDA ST, WAYCROSS, GA 31501(912) 283-1359(912) 283-1362 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Southeast Georgia Primary Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEAST GEORGIA PRIMARY CARE (NPI 1053429688) is a healthcare organization registered as a family medicine in Waycross, Georgia and active in the NPI registry since August 2006. The organization lists Matthew G Prohaska, Doctor, as its authorized official.

NPPES Registry Identity

NPI1053429688
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSOUTHEAST GEORGIA PRIMARY CARE
Location Address409 UVALDA STWaycross, GA 31501-4574
Mailing Address409 Uvalda StWaycross, GA 31501-4574 · (912) 283-1359 · Fax (912) 283-1362
Phone(912) 283-1359
Fax(912) 283-1362
Organization SubpartNo
Authorized OfficialMatthew G ProhaskaDoctor · (912) 283-1359
Enumeration DateAugust 25, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1053429688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

409 UVALDA ST, Waycross, GA 31501
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KALA HODGES FNP-C
Nurse Practitioner (Family)
409 UVALDA ST
WAYCROSS, GA 31501
Ware County (229) 391-3500
LESLIE C. TAYLOR RN, APRN, NP-C
Nurse Practitioner (Family)
409 UVALDA ST
WAYCROSS, GA 31501
Ware County (912) 283-1359
MISS ELLISA A MATHIS FNP'C
Nurse Practitioner (Family)
409 UVALDA ST
WAYCROSS, GA 31501
Ware County (912) 283-1359

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeast Georgia Primary Care's NPI number?

The NPI number for Southeast Georgia Primary Care is 1053429688. It was assigned to this organization in the NPPES registry on August 25, 2006.

Where is Southeast Georgia Primary Care located?

Southeast Georgia Primary Care is located at 409 Uvalda St, Waycross, GA 31501. The listed phone number is (912) 283-1359.

What is Southeast Georgia Primary Care's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Southeast Georgia Primary Care was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.