| Sjc Medical Group Inc- Southside | |
|
410 Mall Boulevard Suite E Savannah GA 31408-4869 | |
| (912) 352-7194 | |
| (912) 352-3131 |
| Full Name | Sjc Medical Group Inc- Southside |
|---|---|
| Speciality | Family Medicine |
| Location | 410 Mall Boulevard, Savannah, Georgia |
| Authorized Official Name and Position | Paul P Hinchey (PRESIDENT/ CEO) |
| Authorized Official Contact | 9128196101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sjc Medical Group Inc- Southside 602 E. 72nd Street Savannah GA 31405-4913 Ph: (912) 819-7878 | Sjc Medical Group Inc- Southside 410 Mall Boulevard Suite E Savannah GA 31408-4869 Ph: (912) 352-7194 |
| NPI Number | 1770509333 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 08/25/2011 |
| Medicare PECOS PAC ID | 9931091618 |
|---|---|
| Medicare Enrollment ID | O20040326001194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770509333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | James Harrington |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265503635 PECOS PAC ID: 0941190888 Enrollment ID: I20040316000970 |
| Provider Name | Martin L Mcroberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982625075 PECOS PAC ID: 7214997527 Enrollment ID: I20041012000811 |
| Provider Name | Jacqueline M Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518989078 PECOS PAC ID: 1052419470 Enrollment ID: I20070608000358 |
| Provider Name | Sharon Kestin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407877590 PECOS PAC ID: 6608965850 Enrollment ID: I20071211000389 |
| Provider Name | Chelsea M Stoever |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700948312 PECOS PAC ID: 9133129463 Enrollment ID: I20091117000493 |
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