Healthcare Provider Details

I. General information

NPI: 1003094848
Provider Name (Legal Business Name): A. REGINALD PILCHER, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115B GARREDD BLVD
AUGUSTA GA
30909-6674
US

IV. Provider business mailing address

1115B GARREDD BLVD
AUGUSTA GA
30909-6674
US

V. Phone/Fax

Practice location:
  • Phone: 706-854-9416
  • Fax: 706-863-8523
Mailing address:
  • Phone: 706-854-9416
  • Fax: 706-863-8523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number017238
License Number StateGA

VIII. Authorized Official

Name: A REGINALD PILCHER
Title or Position: OWNER
Credential: MD
Phone: 706-854-9416