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General NPI Number Information
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NPI Number | 1376897488
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Entity Type | Organization
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Legal Business Name | THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY
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Dates
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Enumeration Date | 10/29/2012
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Last Update Date | 11/13/2012
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Provider Practice Location Address
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Address Line | 163 E TOLLISON ST
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City | BAXLEY
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State | GA
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Zip | 31513-0120
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Country | US
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Telephone | 912-367-9841
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Fax | 912-367-1272
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Provider Business Mailing Address
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Address Line | PO BOX 2070
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City | BAXLEY
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State | GA
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Zip | 31515-2070
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Country | US
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Telephone | 912-367-9841
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Fax | 912-367-1272
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Authorized Official
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Title or Position | CEO
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Name | MR. DALE SPELL
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Credential |
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Telephone | 912-367-9841
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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 | 68488
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License Number State | GA
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