Basic Information
Provider Information
NPI: 1194136549
EntityType: 2
ReplacementNPI:  
OrganizationName: ST. FRANCIS NEUROLOGY, LLC
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Mailing Information
Address1: PO BOX 9388
Address2:  
City: COLUMBUS
State: GA
PostalCode: 319089388
CountryCode: US
TelephoneNumber: 7063202773
FaxNumber: 7065964226
Practice Location
Address1: 2300 MANCHESTER EXPY
Address2: STE A005
City: COLUMBUS
State: GA
PostalCode: 319046805
CountryCode: US
TelephoneNumber: 7063202773
FaxNumber: 7065964226
Other Information
ProviderEnumerationDate: 05/19/2014
LastUpdateDate: 07/27/2015
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AuthorizedOfficialLastName: HEMBREE
AuthorizedOfficialFirstName: GREG
AuthorizedOfficialMiddleName: S.
AuthorizedOfficialTitleorPosition: CFO/SVP
AuthorizedOfficialTelephone: 7063203751
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X  Y193400000X MULTIPLE SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

ID Information
IDTypeStateIssuerDescription
202G70978101GAMEDICARE PTANOTHER
16147905AL MEDICAID
003148563A05GA MEDICAID


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