Organization Name: | PAUL M. SERGENT M.D. P.C. |
NPI Number: | 1205001070 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAUL MONTFORD SERGENT (OWNER) |
Mailing Address: | 701 Hospital Rd Commerce |
State: | GA US |
Postal Code: | 305291166 |
Phone Number: | 7063352100 |
Fax Number: | |
NPI Enumeration Date: | 04/23/2008 |
NPI Last Update Date: | 04/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |