Healthcare Provider Details

I. General information

NPI: 1962922476
Provider Name (Legal Business Name): SAVANNAH PLASTIC SURGICENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7208 HODGSON MEMORIAL DR
SAVANNAH GA
31406-2512
US

IV. Provider business mailing address

7208 HODGSON MEMORIAL DR
SAVANNAH GA
31406-2512
US

V. Phone/Fax

Practice location:
  • Phone: 912-351-5050
  • Fax: 912-351-5051
Mailing address:
  • Phone: 912-351-5050
  • Fax: 912-351-5051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number025-062
License Number StateGA

VIII. Authorized Official

Name: BARBARA L DAVIES
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 912-351-5050