MEDICARE: SAVANNAH OBGYN PC

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
1	174400000X	Specialist	036294	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467467845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAVANNAH OBGYN PC

Provider Business Mailing Address
First Line	:	5356 REYNOLDS ST
Second Line	:	SUITE 410
City	:	SAVANNAH
State	:	GA
Zip	:	31405-6016
Country	:	US
Telephone Number	:	912-355-8136
Fax Number	:	912-352-7014

Provider Business Practice Location Address
First Line	:	5356 REYNOLDS ST
Second Line	:	SUITE 410
City	:	SAVANNAH
State	:	GA
Zip	:	31405-6016
Country	:	US
Telephone Number	:	912-355-8136
Fax Number	:	912-352-7014

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	ALAN SMITH
Credential	:	MD
Telephone Number	:	912-355-8136

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	10/07/2015

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Directions to “SAVANNAH OBGYN PC ” Practice Location

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