Provider Demographics
NPI:1245720689
Name:STARLAND FAMILY PRACTICE
Entity type:Organization
Organization Name:STARLAND FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:EAREHART
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:912-800-1017
Mailing Address - Street 1:9100 WHITE BLUFF RD STE 501
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-4672
Mailing Address - Country:US
Mailing Address - Phone:912-800-1017
Mailing Address - Fax:877-836-3638
Practice Address - Street 1:9100 WHITE BLUFF RD STE 501
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-4672
Practice Address - Country:US
Practice Address - Phone:912-800-1017
Practice Address - Fax:877-836-3638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X
GA65026207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty