Healthcare Provider Details

I. General information

NPI: 1306173810
Provider Name (Legal Business Name): SAVOY MEDICAL MANAGEMENT GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2009
Last Update Date: 03/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 MAIN STREET
ELTON LA
70532
US

IV. Provider business mailing address

801 POINCIANA AVE
MAMOU LA
70554-2243
US

V. Phone/Fax

Practice location:
  • Phone: 337-584-2237
  • Fax: 337-584-2148
Mailing address:
  • Phone: 337-468-5261
  • Fax: 337-468-3342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number149
License Number StateLA

VIII. Authorized Official

Name: MR. MICHAEL W. JOHNSON
Title or Position: PRESIDENT
Credential: CPA
Phone: 337-468-0355