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General NPI Number Information
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NPI Number | 1811425747
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Entity Type | Organization
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Legal Business Name | GOLDEN ISLES EMERGENCY PHYSICIANS LLC
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Dates
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Enumeration Date | 05/23/2017
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Last Update Date | 05/23/2017
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Provider Practice Location Address
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Address Line | 222 PERRY HWY
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City | HAWKINSVILLE
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State | GA
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Zip | 31036-6748
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Country | US
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Telephone | 469-401-2386
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Fax |
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Provider Business Mailing Address
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Address Line | 13137 NOEL ROAD 1600
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City | DALLAS
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State | TX
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Zip | 75240
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Country | US
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Telephone | 469-401-2386
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | TENNA K BEHM
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Credential |
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Telephone | 469-401-2386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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