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NPI Code Detail

MEDICARE: SAINT JOSEPHS MEDICAL GROUP INC

MEDICARE: SAINT JOSEPHS MEDICAL GROUP INC
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
1207Q00000XFamily Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12555OTHERGAGROUP MEDICARE

General Provider Information

NPI Number : 1154349850
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAINT JOSEPHS MEDICAL GROUP INC
Provider Business Mailing Address
First Line : 602 E 72ND STREET
Second Line :
City : SAVANNAH
State : GA
Zip : 31405
Country : US
Telephone Number : 912-819-7878
Fax Number : 912-819-7850
Provider Business Practice Location Address
First Line : 159 WEST RAILROAD ST
Second Line :
City : PEMBROKE
State : GA
Zip : 31321
Country : US
Telephone Number : 912-653-2897
Fax Number : 912-653-4299
Authorized Official
Title or Position : PRESIDENT CEO
Name : PAUL P HINCHEY
Credential :
Telephone Number : 912-819-6901
Provider Enumeration Date : 07/18/2006
Last Update Date : 04/02/2014

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Directions to “SAINT JOSEPHS MEDICAL GROUP INC ” Practice Location

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