# CRISP REGIONAL HOSPITAL

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

## Provider details

- **NPI number:** 1790076966
- **Authorized official:** DR. SAMANTHA DAHLIA BORELAND MD,MHSA (OBSTETRICIAN/GYNECOLOGIST)
- **Authorized official phone:** (229) 276-3101

## Contact information

- **Practice address:** 910 N 5TH ST, CORDELE, GA 31015-3254
- **Practice address phone:** (229) 271-4600
- **Mailing address:** 910 N 5TH ST, CORDELE, GA 31015-3254
- **Mailing address phone:** (229) 271-4600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282NW0100X | Women's Hospital | 65938 | GA | Yes |

## Other

- **Enumeration date:** 04/22/2011
- **Last updated:** 04/22/2011