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General NPI Number Information
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NPI Number | 1295519775
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Entity Type | Organization
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Legal Business Name | SJC MS GENERAL SURGERY, LLC
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Dates
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Enumeration Date | 08/24/2023
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 594 S COLUMBIA AVE STE 100
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City | RINCON
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State | GA
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Zip | 31326-9095
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Country | US
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Telephone | 912-826-4057
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Fax | 912-826-2853
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Provider Business Mailing Address
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Address Line | 836 E 65TH ST STE 22
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City | SAVANNAH
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State | GA
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Zip | 31405-4493
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Country | US
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Telephone | 912-819-2649
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Fax | 912-819-3320
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Authorized Official
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Title or Position | CEO
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Name | PAUL HINCHEY
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Credential |
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Telephone | 912-819-6901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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