Healthcare Provider Details

I. General information

NPI: 1194220939
Provider Name (Legal Business Name): FRANK CONRAD DUERSON III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2018
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5354 REYNOLDS ST SUITE 424
SAVANNAH GA
31405
US

IV. Provider business mailing address

5354 REYNOLDS ST SUITE 424
SAVANNAH GA
31405
US

V. Phone/Fax

Practice location:
  • Phone: 912-819-5999
  • Fax: 912-819-5980
Mailing address:
  • Phone: 912-819-5999
  • Fax: 912-819-5980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number88216
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number88216
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: