Organization
ROBERT A PUMPELLY IV MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY HOOVER (OFFICE MANAGER)
(912) 427-4413
Entity
Organization
Contact information
Practice address
124 MEMORIAL DR, JESUP, GA 31545-0101
(912) 427-4413
(912) 530-6348
Mailing address
124 MEMORIAL DR, JESUP, GA 31545-0101
(912) 427-4413
(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
—
300024546
—
GA
01
—
CH9108
RR MEDICARE
GA
Enumeration date
11/22/2006
Last updated
08/22/2020
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