Healthcare Provider Details

I. General information

NPI: 1225228604
Provider Name (Legal Business Name): LOW COUNTRY OB/GYN, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 01/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 REYNOLDS ST STE 201
SAVANNAH GA
31405-6015
US

IV. Provider business mailing address

5353 REYNOLDS ST STE 201
SAVANNAH GA
31405-6015
US

V. Phone/Fax

Practice location:
  • Phone: 912-355-5755
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number040992
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number040992
License Number StateGA

VIII. Authorized Official

Name: BARRY SCHLAFSTEIN
Title or Position: PRESIDENT
Credential: MD
Phone: 912-920-2995