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General NPI Number Information
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NPI Number | 1205608007
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Entity Type | Organization
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Legal Business Name | DOCTORS TO GO, LLC
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Dates
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Enumeration Date | 10/25/2023
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 400 CEDAR ST
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City | METTER
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State | GA
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Zip | 30439-3338
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Country | US
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Telephone | 912-685-5741
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Fax |
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Provider Business Mailing Address
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Address Line | 116 ANDOVER DR
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City | SAVANNAH
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State | GA
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Zip | 31405-5407
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Country | US
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Telephone | 912-695-7969
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DIANA M HANSEN
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Credential | AO
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Telephone | 912-403-9317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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