Healthcare Provider Details

I. General information

NPI: 1891612503
Provider Name (Legal Business Name): TATTNALL HOSPITAL COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 FREDERICK DR
CLEVELAND MS
38732-2006
US

IV. Provider business mailing address

440 MALL BLVD STE C
SAVANNAH GA
31406-4868
US

V. Phone/Fax

Practice location:
  • Phone: 662-299-2999
  • Fax: 662-846-8989
Mailing address:
  • Phone: 470-705-0086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID ALEX VILLA
Title or Position: CEO
Credential:
Phone: 912-629-7797