Healthcare Provider Details

I. General information

NPI: 1730690561
Provider Name (Legal Business Name): ST. JOSEPH'S/CANDLER OB/GYN PRACTICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2017
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 REYNOLDS STREET
SAVANNAH GA
31405-4913
US

IV. Provider business mailing address

836 E 65TH ST STE 22
SAVANNAH GA
31405-4493
US

V. Phone/Fax

Practice location:
  • Phone: 912-819-7800
  • Fax: 912-819-7850
Mailing address:
  • Phone: 912-819-7171
  • Fax: 912-691-9287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

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