Healthcare Provider Details

I. General information

NPI: 1912657792
Provider Name (Legal Business Name): SAVANNAH AUSTIN JONES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAVANNAH JONES PA-C

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HEALTHY WAY STE 1200
ANDERSON SC
29621-7916
US

IV. Provider business mailing address

PO BOX 100174
COLUMBIA SC
29202-3174
US

V. Phone/Fax

Practice location:
  • Phone: 864-512-6140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5432
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: