Provider Demographics
NPI:1548579923
Name:STEPHEN F PINKERTON, MD, PC
Entity Type:Organization
Organization Name:STEPHEN F PINKERTON, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:PINKERTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-886-7408
Mailing Address - Street 1:PO BOX 609
Mailing Address - Street 2:
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577-1410
Mailing Address - Country:US
Mailing Address - Phone:706-886-7408
Mailing Address - Fax:706-886-6042
Practice Address - Street 1:27 ROCK QUARRY RD
Practice Address - Street 2:
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577-8721
Practice Address - Country:US
Practice Address - Phone:706-886-7408
Practice Address - Fax:706-886-6042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033877208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52049095OtherBCBS GA
GA000471292AMedicaid
GA020015123OtherMEDICARE RAILROAD
GA000471292AMedicaid
GA020015123OtherMEDICARE RAILROAD