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General NPI Number Information
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NPI Number | 1316084122
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Entity Type | Organization
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Legal Business Name | GEORGIA EAR ASSOCIATES PC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4700 WATERS AVE
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City | SAVANNAH
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State | GA
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Zip | 31404-6220
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Country | US
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Telephone | 912-350-5000
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Fax | 912-350-5083
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Provider Business Mailing Address
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Address Line | PO BOX 3720
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City | SAVANNAH
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State | GA
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Zip | 31414-3720
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Country | US
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Telephone | 912-350-5000
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Fax | 912-350-5083
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Authorized Official
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Title or Position | OWNER
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Name | MANNING MILES GOLDSMITH III
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Credential | M.D.
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Telephone | 912-350-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 025161
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License Number State | GA
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