Provider Demographics
NPI:1003217712
Name:CANDLER MEDICAL ONCOLOGY PRACTICE, LLC
Entity Type:Organization
Organization Name:CANDLER MEDICAL ONCOLOGY PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HINCHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-651-5766
Mailing Address - Street 1:836 E 65TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4491
Mailing Address - Country:US
Mailing Address - Phone:912-354-6187
Mailing Address - Fax:912-355-9807
Practice Address - Street 1:225 CANDLER DR STE 300
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6091
Practice Address - Country:US
Practice Address - Phone:912-354-6187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CANDLER HOSPITAL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-12
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty