Individual
PAUL JOSEPH GILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1006 MOUNT VERNON RD, VIDALIA, GA 30474-3029
(912) 537-1221
(912) 537-1012
Mailing address
PO BOX 407, VIDALIA, GA 30475-0407
(912) 537-4986
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
025159
GA
207RC0000X
Cardiovascular Disease Physician
025159
GA
207RI0011X
Interventional Cardiology Physician
Primary
025159
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000348169R
—
GA
01
—
060062628
RAILROAD MEDICARE
GA
Enumeration date
08/09/2005
Last updated
11/04/2020
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