Organization
GEORGE SIDHOM MD PA
Active
Other names
Hernando Pain Management
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEAN M SIDHOM (BILLING/OFFICE MANAGER)
(352) 688-6393
Entity
Organization
Contact information
Practice address
5193 MARINER BLVD, SPRING HILL, FL 34609-1834
(352) 688-6393
(352) 688-1113
Mailing address
PO BOX 10478, BROOKSVILLE, FL 34603-0478
(352) 688-6393
(352) 688-1113
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
97788
BLUE CROSS BLUE SHEILD
FL
Enumeration date
07/20/2006
Last updated
04/03/2013
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