MEDICARE: MR. GEORGE ALBAN PALMER M.D.

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
1	207V00000X	Obstetrics & Gynecology Physician	030658	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194718080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GEORGE ALBAN PALMER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 428
Second Line	:
City	:	STATESBORO
State	:	GA
Zip	:	30459
Country	:	US
Telephone Number	:	912-871-4800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1012 BERMUDA RUN
Second Line	:
City	:	STATESBORO
State	:	GA
Zip	:	30458-0858
Country	:	US
Telephone Number	:	912-871-4800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	10/21/2011

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