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General NPI Number Information
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NPI Number | 1124401591
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Entity Type | Organization
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Legal Business Name | SAVANNAH SURGERY CENTER, LLC
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Dates
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Enumeration Date | 07/03/2015
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Last Update Date | 07/03/2015
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Provider Practice Location Address
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Address Line | 5102 PAULSEN ST BLDG 2
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City | SAVANNAH
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State | GA
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Zip | 31405-4601
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Country | US
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Telephone | 912-354-8331
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Fax | 912-352-9782
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Provider Business Mailing Address
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Address Line | 5102 PAULSEN ST BLDG 2
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City | SAVANNAH
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State | GA
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Zip | 31405-4601
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Country | US
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Telephone | 912-354-8331
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Fax | 912-352-9782
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | NORMAN LEE YATES III
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Credential | MD
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Telephone | 912-354-8331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 050761
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License Number State | GA
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