Healthcare Provider Details
I. General information
NPI: 1811913486
Provider Name (Legal Business Name): CANDLER MEDICAL GROUP, INC. - ISLANDS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/15/2006
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
102 BRYAN WOODS ROAD
SAVANNAH GA
31410-1225
US
IV. Provider business mailing address
602 E. 72ND STREET
SAVANNAH GA
31405-4913
US
V. Phone/Fax
- Phone: 912-898-1122
- Fax: 912-898-9944
- Phone: 912-819-7878
- Fax: 912-819-5044
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAUL
P
HINCHEY
Title or Position: PRESIDENT/CEO
Credential:
Phone: 912-819-6000