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NPI Code Detail

MEDICARE: CANDLER EMERGENCY GROUP, LLC

MEDICARE: CANDLER EMERGENCY GROUP, 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
1363A00000XPhysician Assistant
2363L00000XNurse Practitioner
3207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1437430253
Entity Type Code : Organization
Provider Name (Legal Business Name) : CANDLER EMERGENCY GROUP, LLC
Provider Business Mailing Address
First Line : 200 CORPORATE BLVD
Second Line : SUITE 201
City : LAFAYETTE
State : LA
Zip : 70508-3870
Country : US
Telephone Number : 800-893-9698
Fax Number :
Provider Business Practice Location Address
First Line : 400 CEDAR ST
Second Line :
City : METTER
State : GA
Zip : 30439-3338
Country : US
Telephone Number : 912-685-5741
Fax Number :
Authorized Official
Title or Position : CEO
Name : WILLIAM C SCHUMACHER
Credential : MD
Telephone Number : 800-893-9698
Provider Enumeration Date : 09/07/2011
Last Update Date : 09/07/2011

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