Provider Demographics
NPI:1639622574
Name:S. H. STORY, III, MD, P.C.
Entity Type:Organization
Organization Name:S. H. STORY, III, MD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STACY
Authorized Official - Middle Name:H
Authorized Official - Last Name:STORY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:706-829-3516
Mailing Address - Street 1:PO BOX 3967
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30914-3967
Mailing Address - Country:US
Mailing Address - Phone:864-704-8829
Mailing Address - Fax:706-854-8388
Practice Address - Street 1:501 BLACKBURN DR
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-8201
Practice Address - Country:US
Practice Address - Phone:706-854-8340
Practice Address - Fax:706-854-8388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-27
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA017559207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty