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General NPI Number Information
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NPI Number | 1477908788
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Entity Type | Organization
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Legal Business Name | EFFINGHAM PHYSICIAN PRACTICES, LLC
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Dates
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Enumeration Date | 04/25/2016
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Last Update Date | 04/07/2023
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Provider Practice Location Address
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Address Line | 459 HWY 119 S STE B
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City | SPRINGFIELD
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State | GA
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Zip | 31329-3021
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Country | US
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Telephone | 127-542-5609
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Fax | 912-754-0229
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Provider Business Mailing Address
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Address Line | PO BOX 386
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City | SPRINGFIELD
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State | GA
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Zip | 31329-0386
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Country | US
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Telephone | 912-754-2560
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Fax | 912-754-0229
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Authorized Official
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Title or Position | CEO
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Name | FRAN BAKER-WITT
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Credential |
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Telephone | 912-754-0610
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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 |
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License Number State |
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