Provider Demographics
NPI:1093999708
Name:GOLDEN ISLES COLON & RECTAL CLINIC PC
Entity Type:Organization
Organization Name:GOLDEN ISLES COLON & RECTAL CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-267-6211
Mailing Address - Street 1:3215 SHRINE ROAD
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4385
Mailing Address - Country:US
Mailing Address - Phone:912-267-6211
Mailing Address - Fax:
Practice Address - Street 1:3215 SHRINE RD
Practice Address - Street 2:SUITE 1B
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4387
Practice Address - Country:US
Practice Address - Phone:912-267-6211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty