Provider Demographics
NPI:1376179960
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, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:P
Authorized Official - Last Name:HINCHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-819-6000
Mailing Address - Street 1:5400 SUTLIVE ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4721
Mailing Address - Country:US
Mailing Address - Phone:912-354-6187
Mailing Address - Fax:
Practice Address - Street 1:100 BUCKWALTER PLACE BLVD STE 120
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-5154
Practice Address - Country:US
Practice Address - Phone:843-836-7120
Practice Address - Fax:843-815-8014
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CANDLER HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty