Healthcare Provider Details

I. General information

NPI: 1487899464
Provider Name (Legal Business Name): PHOEBE PHYSICIAN GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2008
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 PALMYRA RD STE 201
ALBANY GA
31701-1593
US

IV. Provider business mailing address

2002 PALMYRA RD STE 201
ALBANY GA
31701-1593
US

V. Phone/Fax

Practice location:
  • Phone: 229-312-5800
  • Fax: 229-312-4315
Mailing address:
  • Phone: 229-312-5800
  • Fax: 229-312-4315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIAN CHURCH
Title or Position: CFO-CAO
Credential:
Phone: 229-312-4067