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General NPI Number Information
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NPI Number | 1487180709
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Entity Type | Organization
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Legal Business Name | SOUTH GEORGIA CENTER FOR CANCER CARE, LLC
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Dates
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Enumeration Date | 05/05/2017
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 27 COACH LEE HILL BLVD.
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City | STATESBORO
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State | GA
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Zip | 30458-4764
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Country | US
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Telephone | 912-764-3037
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Fax | 912-764-3829
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Provider Business Mailing Address
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Address Line | 104 WOODMONT BLVD STE 500 CREDENTIALING DEPT.
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City | NASHVILLE
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State | TN
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Zip | 37205-2245
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Country | US
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Telephone | 615-783-1254
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Fax | 615-783-1082
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. STUART M. BITTING
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Credential |
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Telephone | 615-783-1253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0203X
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Taxonomy Name | Radiation Oncology Clinic/Center
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License Number | NONE
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License Number State | GA
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