Healthcare Provider Details

I. General information

NPI: 1538731690
Provider Name (Legal Business Name): MILTON FARRER STEMBRIDGE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 E 3RD AVE
CORDELE GA
31015-3208
US

IV. Provider business mailing address

922 E JEFFERSON ST STE B
AMERICUS GA
31709-4781
US

V. Phone/Fax

Practice location:
  • Phone: 229-271-4620
  • Fax: 229-271-4614
Mailing address:
  • Phone: 229-924-2383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN248333
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: