Healthcare Provider Details

I. General information

NPI: 1477969749
Provider Name (Legal Business Name): CANDLER ENT PRACTICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2014
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5356 REYNOLDS STREET SUITE 505
SAVANNAH GA
31405
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 912-356-1515
  • Fax: 912-644-0756
Mailing address:
  • Phone: 912-819-7878
  • Fax: 912-819-3555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number025161
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD003814
License Number StateGA

VIII. Authorized Official

Name: MR. PAUL P HINCHEY
Title or Position: PRESIDENT/ CEO
Credential:
Phone: 912-819-9601