Organization Name: | CRH PHYSICIAN PRACTICES LLC |
NPI Number: | 1760856405 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NICOLE BURNAM (ASSISTANT DIRECTOR) |
Mailing Address: | 200 Doctors Dr Suite S Douglas |
State: | GA US |
Postal Code: | 315332201 |
Phone Number: | 9123842353 |
Fax Number: | 9123834679 |
NPI Enumeration Date: | 11/18/2015 |
NPI Last Update Date: | 11/18/2015 |
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: |