Organization
COASTAL PHYSICIANS ALLIANCE, LP
Active
Organization
COASTAL PHYSICIANS ALLIANCE, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY BURNEY (ADMINISTRATOR)
(912) 433-3124
Entity
Organization
Contact information
Practice address
455 S MAIN ST STE 103, HINESVILLE, GA 31313-4354
(912) 408-6868
Mailing address
455 S MAIN ST STE 103, HINESVILLE, GA 31313-4354
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
11/02/2011
Last updated
11/02/2011
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