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Individual

DR. CATHLEEN WOOD QUILLIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1107 E 66TH ST, SAVANNAH, GA 31404-5701
(912) 350-8404
(912) 350-8067
Mailing address
1501 COLLIERS CREEK RD, WATKINSVILLE, GA 30677
(706) 769-4141
(912) 350-8067

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
045924
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000904615A
MEDICAID ID FROM OLD GROUP
GA
01
08BBVCP
MEDICARE PTAN FROM OLD GROUP
GA
05
296899578B
GA
05
GA1017
SC
01
P00778527
RR MEDICARE
GA
Enumeration date
09/01/2006
Last updated
06/02/2011
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