Healthcare Provider Details

I. General information

NPI: 1285132415
Provider Name (Legal Business Name): TATTNALL HOSPITAL COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380A CEDAR ST
METTER GA
30439
US

IV. Provider business mailing address

440 MALL BLVD STE C
SAVANNAH GA
31406-4868
US

V. Phone/Fax

Practice location:
  • Phone: 800-827-6536
  • Fax: 912-644-5260
Mailing address:
  • Phone: 912-629-3527
  • Fax: 912-644-3369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID ALEX VILLA
Title or Position: CEO
Credential:
Phone: 912-629-7797