Basic Information
| Provider Information | |||||||||
| NPI: | 1568784544 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JEANNE M HUNGERPILLER MD LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 836 E 65TH ST | ||||||||
| Address2: | BUILDING # 5 | ||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314054434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9123561747 | ||||||||
| FaxNumber: | 9123524065 | ||||||||
| Practice Location | |||||||||
| Address1: | 836 E 65TH ST | ||||||||
| Address2: | BUILDING # 5 | ||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314054434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9123561747 | ||||||||
| FaxNumber: | 9123524065 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2010 | ||||||||
| LastUpdateDate: | 02/18/2010 | ||||||||
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| AuthorizedOfficialLastName: | RICE | ||||||||
| AuthorizedOfficialFirstName: | JACQUELINE | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9123561747 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | 031985 | GA | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
ID Information
| ID | Type | State | Issuer | Description | 010064647 | 01 | GA | RAILROAD MEDICARE | OTHER | 000482941D | 05 | GA | MEDICAID |