Organization
JESUP EMERGENCY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT J BUNKER (CHAIRMAN/PRESIDENT/CEO)
(904) 805-1300
Entity
Organization
Contact information
Practice address
865 S 1ST ST, JESUP, GA 31545-0210
(912) 427-6811
Mailing address
PO BOX 532855, ATLANTA, GA 30353-2855
(904) 805-1300
(904) 805-1302
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04134
BCBS
GA
Enumeration date
05/03/2006
Last updated
04/20/2008
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