Individual
DR. JAMES FENTEM SMALL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 BRAMPTON AVE, STATESBORO, GA 30458-0856
(912) 871-6206
(912) 681-8558
Mailing address
1310 BRAMPTON AVE, STATESBORO, GA 30458-0851
(912) 871-6206
(912) 681-8558
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
072690
GA
207V00000X
Obstetrics & Gynecology Physician
D89324
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003150434B
—
GA
01
—
20216I5739
MEDICARE
GA
01
—
P01575019
RR MEDICARE
—
Enumeration date
10/15/2007
Last updated
12/31/2025
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