Organization
BULLOCH PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELODY K LIGHTSEY (OFFICE MANAGER)
(912) 871-4847
Entity
Organization
Contact information
Practice address
1497 FAIR RD, STE 200, STATESBORO, GA 30458-0822
(912) 871-4847
(912) 871-5562
Mailing address
1497 FAIR RD, STE 200, STATESBORO, GA 30458-0822
(912) 871-4847
(912) 871-5562
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
06/01/2007
Last updated
08/22/2020
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