Provider Demographics
NPI:1639485394
Name:BACON COUNTY HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:BACON COUNTY HEALTH SERVICES, INC.
Other - Org Name:SOUTH GEORGIA ORTHOPAEDIC GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-632-8961
Mailing Address - Street 1:302 S WAYNE ST
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:GA
Mailing Address - Zip Code:31510-2922
Mailing Address - Country:US
Mailing Address - Phone:912-632-8961
Mailing Address - Fax:912-632-5000
Practice Address - Street 1:205 S WAYNE ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:GA
Practice Address - Zip Code:31510-2919
Practice Address - Country:US
Practice Address - Phone:912-632-0260
Practice Address - Fax:912-632-9272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA063810207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty