Provider Demographics
NPI:1922013473
Name:EAST GEORGIA EMERGENCY PHYSICIANS PC
Entity type:Organization
Organization Name:EAST GEORGIA EMERGENCY PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:P
Authorized Official - Last Name:HERRINGTON
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:912-865-9353
Mailing Address - Street 1:PO BOX 566
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30459-0566
Mailing Address - Country:US
Mailing Address - Phone:912-865-9353
Mailing Address - Fax:912-865-4175
Practice Address - Street 1:660 SNOOPY LN
Practice Address - Street 2:
Practice Address - City:PORTAL
Practice Address - State:GA
Practice Address - Zip Code:30450-4802
Practice Address - Country:US
Practice Address - Phone:912-865-9353
Practice Address - Fax:912-865-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty