Healthcare Provider Details

I. General information

NPI: 1912938366
Provider Name (Legal Business Name): LINDA J WINDERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 STEPHENSON AVE
SAVANNAH GA
31405-5998
US

IV. Provider business mailing address

322 STEPHENSON AVE
SAVANNAH GA
31405-5998
US

V. Phone/Fax

Practice location:
  • Phone: 912-354-3130
  • Fax:
Mailing address:
  • Phone: 912-354-3130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number042146
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: