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NPI Code Detail

MEDICARE: OGLETHORPE EMERGENCY PHYSICIANS

MEDICARE: OGLETHORPE EMERGENCY PHYSICIANS
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
1207P00000XEmergency Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1907942OTHERGABLUE SHIELD

General Provider Information

NPI Number : 1801068796
Entity Type Code : Organization
Provider Name (Legal Business Name) : OGLETHORPE EMERGENCY PHYSICIANS
Provider Business Mailing Address
First Line : PO BOX 13731
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19101-3731
Country : US
Telephone Number : 800-444-7009
Fax Number : 800-305-3233
Provider Business Practice Location Address
First Line : 601 DALLAS HWY
Second Line :
City : VILLA RICA
State : GA
Zip : 30180-1202
Country : US
Telephone Number : 770-459-7100
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JAMES MURPHY
Credential :
Telephone Number : 800-355-0808
Provider Enumeration Date : 03/31/2008
Last Update Date : 04/20/2008

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