Healthcare Provider Details

I. General information

NPI: 1710564273
Provider Name (Legal Business Name): MANON DOUCET MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5356 REYNOLDS ST STE 505
SAVANNAH GA
31405-6017
US

IV. Provider business mailing address

5356 REYNOLDS ST STE 505
SAVANNAH GA
31405-6017
US

V. Phone/Fax

Practice location:
  • Phone: 912-356-1515
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number113627
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: