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Individual

DR. ROBERT ALLEN PUMPELLY IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
124 MEMORIAL DR, JESUP, GA 31545-0101
(912) 427-4413
(912) 530-6348
Mailing address
241 IVY ST, JESUP, GA 31546-3647
(912) 427-7182
(912) 530-6348

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
022461
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000066789M
GA
01
027470
BLUE CROSS BLUE SHIELD
GA
05
300024546
GA
Enumeration date
08/22/2005
Last updated
07/09/2007
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