Healthcare Provider Details

I. General information

NPI: 1962104497
Provider Name (Legal Business Name): ALEXIS LOTT BIALOUSZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 LEXINGTON AVE
SAVANNAH GA
31404-5502
US

IV. Provider business mailing address

1126 W 12TH ST
ALMA GA
31510-1814
US

V. Phone/Fax

Practice location:
  • Phone: 912-350-7171
  • Fax:
Mailing address:
  • Phone: 912-367-9559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number110388
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: