MEDICARE: CANDLER ENT PRACTICE, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	AUD003814	GA
2	207Y00000X	Otolaryngology Physician	025161	GA

General Provider Information

NPI Number	:	1477969749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANDLER ENT PRACTICE, LLC

Provider Business Mailing Address
First Line	:	836 E 65TH ST STE 22
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-4493
Country	:	US
Telephone Number	:	912-819-7878
Fax Number	:	912-819-3555

Provider Business Practice Location Address
First Line	:	5356 REYNOLDS STREET
Second Line	:	SUITE 505
City	:	SAVANNAH
State	:	GA
Zip	:	31405
Country	:	US
Telephone Number	:	912-356-1515
Fax Number	:	912-644-0756

Authorized Official
Title or Position	:	PRESIDENT/ CEO
Name	:	MR. PAUL P HINCHEY
Credential	:
Telephone Number	:	912-819-9601

Provider Enumeration Date	:	07/08/2014
Last Update Date	:	06/15/2026

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Directions to “CANDLER ENT PRACTICE, LLC ” Practice Location

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