Healthcare Provider Details

I. General information

NPI: 1205608007
Provider Name (Legal Business Name): DOCTORS TO GO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2023
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 CEDAR ST
METTER GA
30439-3338
US

IV. Provider business mailing address

116 ANDOVER DR
SAVANNAH GA
31405-5407
US

V. Phone/Fax

Practice location:
  • Phone: 912-685-5741
  • Fax:
Mailing address:
  • Phone: 912-695-7969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DIANA M HANSEN
Title or Position: AUTHORIZED OFFICIAL
Credential: AO
Phone: 912-403-9317