Individual
JACQUELINE ELIZABETH HUNTLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1107 E 66TH ST, SAVANNAH, GA 31404-5701
(912) 350-8404
(912) 350-8067
Mailing address
1107 E 66TH ST, SAVANNAH, GA 31404-5701
(912) 350-8404
(912) 350-8067
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
048428
GA
208D00000X
General Practice Physician
048428
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003116232A
—
GA
05
—
GA1255
—
SC
01
—
P01027627
RAILROAD MEDICARE
GA
Enumeration date
02/04/2009
Last updated
07/24/2012
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