Packer Medical Services,LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PACKER MEDICAL SERVICES,LLC

Practice address

709 Knight Ave
Waycross, GA 31501-1943

Phone

(912) 283-2311

Fax

(912) 283-8204

NPI assigned

Jan 24, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert Milford Packer III, M.D.

Title

Owner

Phone

(912) 283-2311

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Packer Medical Services Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399507200000",
    "number": "1124441308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 KNIGHT AVE",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315011943",
            "telephone_number": "912-283-2311",
            "fax_number": "912-283-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 KNIGHT AVE",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315011943",
            "telephone_number": "912-283-2311",
            "fax_number": "912-283-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACKER MEDICAL SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-24",
        "last_updated": "2014-05-08",
        "status": "A",
        "authorized_official_last_name": "PACKER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "MILFORD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-283-2311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00151665C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Packer Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.