# CRISP REGIONAL HOSPITAL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CRISP REGIONAL HOSPITAL, INC
- **Other names:** Boreland and Cao OBGYN
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1255606216
- **Legal business name:** CRISP REGIONAL HOSPITAL, INC
- **Authorized official:** JAMES W MILLER (DIRECTOR PHYSICIAN PRACTICES)
- **Authorized official phone:** (229) 271-4676

## Contact information

- **Practice address:** 910 N 5TH ST, CORDELE, GA 31015-3254
- **Practice address phone:** (229) 276-3038
- **Practice address fax:** (229) 276-3150
- **Mailing address:** 910 N 5TH ST, CORDELE, GA 31015-3254
- **Mailing address phone:** (229) 276-3038
- **Mailing address fax:** (229) 276-3150

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/09/2012
- **Last updated:** 03/09/2012