Southland Bainbridge Hospitalist Group, LLC

Organization Active NPI Hospitalist Physician · Bainbridge, GA

NPI 1356735336 · NPPES record last updated Mar 27, 2015

Key facts

NPI
1356735336
Entity type
Organization (NPI type 2)
Primary specialty
Hospitalist Physician 208M00000X
Legal business name
SOUTHLAND BAINBRIDGE HOSPITALIST GROUP, LLC
Practice address
1500 E Shotwell St
Bainbridge, GA 39819-4256
Phone
(229) 236-0831
NPI assigned
Mar 27, 2015
Organization subpart
No

Authorized official

Name
Stephanie L Fletcher
Title
Cfo
Phone
(229) 520-7115

Practitioners 164

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 164

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20150616002069 GA Part B Supplier - Clinic/Group Practice 7214248335 Receives reassigned benefits from 163 practitioners
Practice locations: Camilla, GA; Thomasville, GA; Reidsville, GA; Quitman, GA; Nashville, GA; Lakeland, GA; Homerville, GA; Hinesville, GA…

National Provider Directory

Locations

462 Elma G Miles Pkwy
Hinesville, GA 31313
Phone (888) 829-0068

903 N Court St
Quitman, GA 31643
Phone (229) 263-4531

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208M00000X Yes

Addresses

Primary practice location

1500 E Shotwell St
Bainbridge, GA 39819-4256

Mailing address

100 S Madison St
Thomasville, GA 31792-5473
Phone (229) 236-0831

Other providers in Bainbridge, GA

All providers in Bainbridge, GA · Hospitalist Physician in Georgia

Sources for this page

Verify at the official NPI Registry.