MEDICARE: PEACH PHYSICIAN SERVICES, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363A00000X	Physician Assistant
2	363L00000X	Nurse Practitioner
3	208M00000X	Hospitalist Physician

General Provider Information

NPI Number	:	1235821752
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACH PHYSICIAN SERVICES, PC

Provider Business Mailing Address
First Line	:	200 CORPORATE BLVD
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-3870
Country	:	US
Telephone Number	:	800-893-9698
Fax Number	:

Provider Business Practice Location Address
First Line	:	1960 247 CONNECTOR
Second Line	:
City	:	BYRON
State	:	GA
Zip	:	31008-5663
Country	:	US
Telephone Number	:	478-654-2000
Fax Number	:	478-825-4444

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. DAVID SCHILLINGER
Credential	:	MD
Telephone Number	:	337-609-1221

Provider Enumeration Date	:	05/23/2023
Last Update Date	:	05/23/2023

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