Provider Demographics
NPI:1477908788
Name:EFFINGHAM PHYSICIAN PRACTICES, LLC
Entity Type:Organization
Organization Name:EFFINGHAM PHYSICIAN PRACTICES, LLC
Other - Org Name:EFFINGHAM MEDICAL ONCOLOGY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER-WITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-754-0610
Mailing Address - Street 1:PO BOX 386
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:GA
Mailing Address - Zip Code:31329-0386
Mailing Address - Country:US
Mailing Address - Phone:912-754-2560
Mailing Address - Fax:912-754-0229
Practice Address - Street 1:459 HWY 119 S STE B
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:GA
Practice Address - Zip Code:31329-3021
Practice Address - Country:US
Practice Address - Phone:127-542-5609
Practice Address - Fax:912-754-0229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty