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General NPI Number Information
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NPI Number | 1548536022
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Entity Type | Organization
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Legal Business Name | DENICE STARLEY, DO, LLC
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 03/28/2012
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Provider Practice Location Address
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Address Line | 256 SCRANTON CONNECTOR STE 112
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City | BRUNSWICK
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State | GA
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Zip | 31525-0557
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Country | US
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Telephone | 702-622-7983
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Fax | 912-434-6061
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Provider Business Mailing Address
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Address Line | 132 W POINT PLANTATION PKWY
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City | ST SIMONS ISLAND
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State | GA
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Zip | 31522-5834
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Country | US
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Telephone | 702-622-7983
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Fax | 912-434-6061
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | DR. DENICE STARLEY
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Credential | D.O.
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Telephone | 702-622-7983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 065618
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License Number State | GA
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