Provider Demographics
NPI:1306849583
Name:PILCHER, GEORGE S (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:S
Last Name:PILCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 KING STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4736
Mailing Address - Country:US
Mailing Address - Phone:904-388-1820
Mailing Address - Fax:904-388-1827
Practice Address - Street 1:1824 KING STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4736
Practice Address - Country:US
Practice Address - Phone:904-388-1820
Practice Address - Fax:904-388-1827
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46228207RC0000X
GA020793207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4047454OtherAETNA
GA00277681CMedicaid
FL15989OtherBCBS
FL062519100Medicaid
GA141552OtherBCBS
GA00277681BMedicaid
FL208067OtherAVMED
FL15989OtherBCBS
FL060011695Medicare ID - Type UnspecifiedRAILROAD MCARE
GA141552OtherBCBS
FL15989YMedicare ID - Type Unspecified