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General NPI Number Information
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NPI Number | 1144698887
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Entity Type | Individual
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Provider Name | OSCAR TEAL NP
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Gender | Male
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Dates
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Enumeration Date | 09/11/2015
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Last Update Date | 03/01/2021
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Provider Practice Location Address
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Address Line | 902 N 7TH ST
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City | CORDELE
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State | GA
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Zip | 31015-3234
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Country | US
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Telephone | 229-276-3100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5007
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City | CORDELE
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State | GA
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Zip | 31010-5007
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Country | US
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Telephone | 229-276-3100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN215607
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License Number State | GA
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