Healthcare Provider Details

I. General information

NPI: 1154349850
Provider Name (Legal Business Name): SAINT JOSEPHS MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 04/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 WEST RAILROAD ST
PEMBROKE GA
31321
US

IV. Provider business mailing address

602 E 72ND STREET
SAVANNAH GA
31405
US

V. Phone/Fax

Practice location:
  • Phone: 912-653-2897
  • Fax: 912-653-4299
Mailing address:
  • Phone: 912-819-7878
  • Fax: 912-819-7850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PAUL P HINCHEY
Title or Position: PRESIDENT CEO
Credential:
Phone: 912-819-6901