NPI age
18 years
Enumerated 2007-08-27
● Active Type 2 · Organization
Moultrie Pediatrics, Llc
Moultrie Pediatrics, Llc is 1 of 2726 pediatrics organizations in Georgia.
Primary specialty
Pediatrics
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Wills
Owner
Last NPPES update
2011-10-27
Source: monthly bulk 2026-05
How this organization compares
Across 2726 active pediatrics providers in Georgia.
NPI age
18 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-08Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
1 Sweet Bay Ct, Suite A
Moultrie, GA 317686756
Mailing address
Po Box 129
Moultrie, GA 317760129
Authorized official
Marion A Wills, M.D.
Owner
📞 2299851293
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Olivia Simpson, NP Registered Nurse NPI 1497214654
- Lawrence Ukpong, DO Internal Medicine NPI 1376700807
Specialties
-
Pediatrics PrimaryA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 3083 | PEACHSTATE |
| 01 (GA) | 396284 | WELLCARE |
| 05 (GA) | 300035718A |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Children's Medical Group of SW GA
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.