Southeast Georgia Pediatrics
LBN: Southeast Georgia Pediatrics
Southeast Georgia Pediatrics is an health care organization with primary practice located at 1701 Boulevard Sq Ste D , Waycross GA 31501-8022. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty.
Southeast Georgia Pediatrics can be contacted via phone (912) 387-0445, or through Kallay, Eugene Wynn via phone (478) 737-7653.
Contact Information
Primary practice address
1701 Boulevard Sq Ste D
Waycross GA 31501-8022
Phone: (912) 387-0445
Fax: (912) 226-3513
Website:
Authorized official contact:
Name: Kallay, Eugene Wynn Doctor of Medicine (MD)
Phone: (478) 737-7653
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | 041044 | Georgia |
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | 018950 | Georgia |
Profile Details
| NPI number | 1457613192 |
|---|---|
| LBN Legal business name | Southeast Georgia Pediatrics |
| DBA Doing business as | |
| Authorized official | Kallay, Eugene Wynn Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 8th, 2012 |
| Last updated | Jun 15th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457613192 | NPPES |
| Other | 1780767665 | NPI | |
| Other | 1063595973 | NPI |
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