MEDICARE: CANDLER MEDICAL GROUP INC - MERCY

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	207R00000X	Internal Medicine Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1770509333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANDLER MEDICAL GROUP INC - MERCY

Provider Business Mailing Address
First Line	:	602 E. 72ND STREET
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-4913
Country	:	US
Telephone Number	:	912-819-7878
Fax Number	:	912-819-5044

Provider Business Practice Location Address
First Line	:	410 MALL BOULEVARD
Second Line	:	SUITE E
City	:	SAVANNAH
State	:	GA
Zip	:	31408-4869
Country	:	US
Telephone Number	:	912-352-7194
Fax Number	:	912-352-3131

Authorized Official
Title or Position	:	PRESIDENT/ CEO
Name	:	PAUL P HINCHEY
Credential	:
Telephone Number	:	912-819-6101

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	08/25/2011

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