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GOLDEN ISLES PEDIATRICS INC NPI 1104938703


NPI Information

NPI: 1104938703
Provider Name: GOLDEN ISLES PEDIATRICS INC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1919 GLYNN AVE
SUITE 60
BRUNSWICK, GA
ZIP 31520
Phone: (912) 265-4843
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GOLDEN ISLES PEDIATRICS INC is a specialist in Brunswick, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. GOLDEN ISLES PEDIATRICS INC NPI is 1104938703. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1919 GLYNN AVE
SUITE 60
BRUNSWICK, GA
ZIP 31520-176
Phone: (912) 265-4843
Fax: (912) 265-4869

The provider's authorized official is Heather A Svenson .
The authorized official title is President and has the following contact phone number (912) 265-4843.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 1/30/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist050841GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1699850421AMEDICAIDGEORGIA
233619OTHERGEORGIAWELLCARE HEALTH PLAN
3336419OTHERGEORGIAWELLCARE
410061954OTHERGEORGIAAMERIGROUP PROVIDER #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.