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General NPI Number Information
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NPI Number | 1790183622
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Entity Type | Organization
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Legal Business Name | PAULINE L. JACINTO MD
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Dates
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Enumeration Date | 12/09/2014
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Last Update Date | 06/15/2015
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Provider Practice Location Address
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Address Line | 104 LAKESHORE DR STE B
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City | SAINT MARYS
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State | GA
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Zip | 31558-3809
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Country | US
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Telephone | 912-576-5249
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Fax | 912-576-8686
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Provider Business Mailing Address
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Address Line | 10 TEE LN
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City | ST SIMONS ISLAND
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State | GA
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Zip | 31522-5157
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Country | US
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Telephone | 646-283-3412
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Fax | 912-576-8686
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Authorized Official
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Title or Position | MD
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Name | DR. PAUILNE LAGGUI JACINTO
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Credential | MD
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Telephone | 646-283-3412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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