Healthcare Provider Details

I. General information

NPI: 1457891350
Provider Name (Legal Business Name): A REGINALD PILCHER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2017
Last Update Date: 02/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3652 J DEWEY GRAY CIR
AUGUSTA GA
30909-1867
US

IV. Provider business mailing address

3652 J DEWEY GRAY CIR
AUGUSTA GA
30909-1867
US

V. Phone/Fax

Practice location:
  • Phone: 706-854-9416
  • Fax: 706-364-5455
Mailing address:
  • Phone: 706-854-9416
  • Fax: 706-364-5455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number027238
License Number StateGA

VIII. Authorized Official

Name: PAMELA PILCHER
Title or Position: OFFICE MANAGER
Credential: NP
Phone: 706-854-9416