Provider Demographics
NPI:1811222789
Name:GRACE A PILCHER,MD LLC
Entity Type:Organization
Organization Name:GRACE A PILCHER,MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PILCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-722-8817
Mailing Address - Street 1:820 SAINT SEBASTIAN WAY
Mailing Address - Street 2:STE 5E
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2643
Mailing Address - Country:US
Mailing Address - Phone:706-364-3741
Mailing Address - Fax:706-364-5573
Practice Address - Street 1:820 SAINT SEBASTIAN WAY
Practice Address - Street 2:STE 5E
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2643
Practice Address - Country:US
Practice Address - Phone:706-364-3741
Practice Address - Fax:706-364-5573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-12
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0485152084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
202G138238Medicare PIN