# PHILIP TODARO, D.O., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700064482
- **Authorized official:** DR. PHILIP TODARO D.O. (PRESIDENT/PHYSICIAN)
- **Authorized official phone:** (229) 246-4888

## Contact information

- **Practice address:** 1516 E EVANS ST, BAINBRIDGE, GA 39819-4363
- **Practice address phone:** (229) 246-4888
- **Practice address fax:** (229) 246-4881
- **Mailing address:** 1516 E EVANS ST, BAINBRIDGE, GA 39819-4363
- **Mailing address phone:** (229) 246-4888
- **Mailing address fax:** (229) 246-4881

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 015330 | GA | Yes |

## Other

- **Enumeration date:** 02/05/2008
- **Last updated:** 06/02/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000024527A | — | GA |
| 01 | — | 1659384816 | BLUE CROSS/BLUE SHIELD | GA |