Provider Demographics
NPI:1942561485
Name:ST. FRANCIS ELECTROPHYSIOLOGIST GROUP LLC
Entity Type:Organization
Organization Name:ST. FRANCIS ELECTROPHYSIOLOGIST GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/SVP
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:S
Authorized Official - Last Name:HEMBREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-320-3751
Mailing Address - Street 1:PO BOX 9028
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908-9028
Mailing Address - Country:US
Mailing Address - Phone:706-320-3266
Mailing Address - Fax:706-320-3267
Practice Address - Street 1:2300 MANCHESTER EXPY
Practice Address - Street 2:STE 1005
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6877
Practice Address - Country:US
Practice Address - Phone:706-320-3266
Practice Address - Fax:706-320-3267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-31
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003126733AMedicaid
AL138983Medicaid
GA202G705960Medicare PIN