Provider Demographics
NPI:1568784544
Name:JEANNE M HUNGERPILLER MD LLC
Entity Type:Organization
Organization Name:JEANNE M HUNGERPILLER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-356-1747
Mailing Address - Street 1:836 E 65TH ST
Mailing Address - Street 2:BUILDING # 5
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4434
Mailing Address - Country:US
Mailing Address - Phone:912-356-1747
Mailing Address - Fax:912-352-4065
Practice Address - Street 1:836 E 65TH ST
Practice Address - Street 2:BUILDING # 5
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4434
Practice Address - Country:US
Practice Address - Phone:912-356-1747
Practice Address - Fax:912-352-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031985261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA010064647OtherRAILROAD MEDICARE
GA000482941DMedicaid
GAF13189Medicare UPIN
GA01BDHMKMedicare PIN