Basic Information
| Provider Information | |||||||||
| NPI: | 1841208279 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POLHILL | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2406 BELLEVUE RD | ||||||||
| Address2: | 11 ERIN OFFICE PARK | ||||||||
| City: | DUBLIN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 310212842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4782752454 | ||||||||
| FaxNumber: | 4782750991 | ||||||||
| Practice Location | |||||||||
| Address1: | 2406 BELLEVUE RD | ||||||||
| Address2: | 11 ERIN OFFICE PARK | ||||||||
| City: | DUBLIN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 310212842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4782752454 | ||||||||
| FaxNumber: | 4782750991 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2006 | ||||||||
| LastUpdateDate: | 09/13/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 2006-00364 | NC | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 059001 | GA | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.