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General NPI Number Information
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NPI Number | 1174348296
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Entity Type | Organization
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Legal Business Name | SOUTHERN HEALTH AND WELLNESS
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 1098 BERMUDA RUN STE 6
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City | STATESBORO
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State | GA
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Zip | 30458-0878
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Country | US
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Telephone | 912-259-9904
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Fax |
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Provider Business Mailing Address
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Address Line | 1098 BERMUDA RUN STE 6
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City | STATESBORO
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State | GA
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Zip | 30458-0878
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Country | US
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Telephone | 912-259-9904
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Fax | 912-623-2319
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Authorized Official
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Title or Position | OWNER
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Name | JAMES L HILLER
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Credential | MD
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Telephone | 912-681-3111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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