Provider Demographics
NPI:1306845029
Name:VICTOR, JULES III (MD)
Entity Type:Individual
Prefix:DR
First Name:JULES
Middle Name:
Last Name:VICTOR
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 EISENHOWER DR
Mailing Address - Street 2:BLDG. 2
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3928
Mailing Address - Country:US
Mailing Address - Phone:912-527-5100
Mailing Address - Fax:912-527-5149
Practice Address - Street 1:1326 EISENHOWER DR
Practice Address - Street 2:BLDG. 2
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3928
Practice Address - Country:US
Practice Address - Phone:912-527-5100
Practice Address - Fax:912-527-5149
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA018122207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG18122Medicaid
GA681681OtherBCBS
GA000147892DMedicaid
GA110128602OtherRR MEDICARE
GA11BDLDQMedicare ID - Type Unspecified
GA110128602OtherRR MEDICARE