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NPI Code Detail

MEDICARE: TATTNALL HOSPITAL COMPANY, LLC

MEDICARE: TATTNALL HOSPITAL COMPANY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician
2207Q00000XFamily Medicine Physician
3261QR1300XRural Health Clinic/Center

General Provider Information

NPI Number : 1285893818
Entity Type Code : Organization
Provider Name (Legal Business Name) : TATTNALL HOSPITAL COMPANY, LLC
Provider Business Mailing Address
First Line : 440 MALL BLVD STE C
Second Line :
City : SAVANNAH
State : GA
Zip : 31406-4868
Country : US
Telephone Number : 912-644-3340
Fax Number : 912-644-5398
Provider Business Practice Location Address
First Line : 125 MEMORIAL DRIVE
Second Line :
City : REIDSVILLE
State : GA
Zip : 30453-4605
Country : US
Telephone Number : 912-557-3434
Fax Number : 912-557-6760
Authorized Official
Title or Position : CEO
Name : DAVID ALEX VILLA
Credential :
Telephone Number : 912-629-7797
Provider Enumeration Date : 06/09/2008
Last Update Date : 01/14/2026

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Directions to “TATTNALL HOSPITAL COMPANY, LLC ” Practice Location

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