Organization
ELITE MEDICAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK B PULLIN (OFFICE MANAGER)
(912) 375-4400
Entity
Organization
Contact information
Practice address
143 S TALLAHASSEE ST, HAZLEHURST, GA 31539-6466
(912) 375-4400
(911) 237-5449
Mailing address
PO BOX 729, HAZLEHURST, GA 31539-0729
(912) 375-4400
(912) 375-4499
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
049936
GA
174400000X
Specialist
Primary
051068
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
362318407A
—
GA
05
—
455996743A
—
GA
Enumeration date
11/02/2007
Last updated
05/01/2008
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