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General NPI Number Information
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NPI Number | 1225072846
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Entity Type | Organization
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Legal Business Name | PHOEBE PUTNEY MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 507 W 3RD AVE STE 100
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City | ALBANY
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State | GA
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Zip | 31701-1958
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Country | US
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Telephone | 229-312-9050
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2548
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City | ALBANY
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State | GA
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Zip | 31702-2548
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Country | US
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Telephone | 229-312-5800
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Fax | 229-312-5853
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Authorized Official
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Title or Position | SR VP PHYSICIAN SERVICES
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Name | FRANK F MIDDLETON III
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Credential | MD
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Telephone | 229-312-4055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 040445
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License Number State | GA
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