Provider Demographics
NPI:1831493048
Name:AMY PEARSON, P.C.
Entity Type:Organization
Organization Name:AMY PEARSON, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-756-3005
Mailing Address - Street 1:2453 US HIGHWAY 17
Mailing Address - Street 2:SUITE G
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-5959
Mailing Address - Country:US
Mailing Address - Phone:912-756-3005
Mailing Address - Fax:912-756-5921
Practice Address - Street 1:2453 US HIGHWAY 17
Practice Address - Street 2:SUITE G
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-5959
Practice Address - Country:US
Practice Address - Phone:912-756-3005
Practice Address - Fax:912-756-5921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA47638174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty