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NPI Code Detail

MEDICARE: PAUL JOSEPH GILES, M.D., LLC

MEDICARE: PAUL JOSEPH GILES, M.D., LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RI0011XInterventional Cardiology PhysicianGA

General Provider Information

NPI Number : 1114359916
Entity Type Code : Organization
Provider Name (Legal Business Name) : PAUL JOSEPH GILES, M.D., LLC
Provider Business Mailing Address
First Line : 1006 MOUNT VERNON RD
Second Line :
City : VIDALIA
State : GA
Zip : 30474-3029
Country : US
Telephone Number : 912-537-1221
Fax Number : 912-537-1012
Provider Business Practice Location Address
First Line : 1006 MOUNT VERNON RD
Second Line :
City : VIDALIA
State : GA
Zip : 30474-3029
Country : US
Telephone Number : 912-537-1221
Fax Number : 912-537-1012
Authorized Official
Title or Position : CFO VP FINANCE
Name : TONY M OSTEEN
Credential :
Telephone Number : 912-537-8691
Provider Enumeration Date : 08/02/2013
Last Update Date : 08/02/2013

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