Healthcare Provider Details

I. General information

NPI: 1396986295
Provider Name (Legal Business Name): WRIGHTINGTON RHEUMATOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6413 WATERS AVE STE 101
SAVANNAH GA
31406-2711
US

IV. Provider business mailing address

6413 WATERS AVE STE 101
SAVANNAH GA
31406-2711
US

V. Phone/Fax

Practice location:
  • Phone: 912-352-7960
  • Fax:
Mailing address:
  • Phone: 912-352-7960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number046014
License Number StateGA

VIII. Authorized Official

Name: THAN WIN
Title or Position: REGISTERED AGENT
Credential:
Phone: 912-352-7960