Healthcare Provider Details

I. General information

NPI: 1851662340
Provider Name (Legal Business Name): SAVOY MEDICAL MANAGEMENT GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2012
Last Update Date: 01/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1413 7TH ST SUITE A
MAMOU LA
70554-2214
US

IV. Provider business mailing address

1413 7TH ST SUITE A
MAMOU LA
70554-2214
US

V. Phone/Fax

Practice location:
  • Phone: 337-468-3638
  • Fax: 337-468-2140
Mailing address:
  • Phone: 337-468-3638
  • Fax: 337-468-2140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: ROBERT FLAKE
Title or Position: CEO
Credential:
Phone: 337-469-0355