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General NPI Number Information
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NPI Number | 1316667249
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Entity Type | Organization
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Legal Business Name | UNCTION UROGYNECOLOGY, LLC
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Dates
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Enumeration Date | 08/31/2022
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | 212 US HIGHWAY 80 E
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City | POOLER
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State | GA
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Zip | 31322-2608
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Country | US
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Telephone | 912-988-7894
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Fax | 912-348-3418
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Provider Business Mailing Address
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Address Line | 101 BLUE MOON XING STE 3
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City | POOLER
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State | GA
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Zip | 31322-9798
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Country | US
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Telephone | 912-988-7894
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Fax | 912-348-3418
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Authorized Official
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Title or Position | UROGYNECOLOGIST
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Name | DR. TONI SYLVESTER
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Credential | MD, FACOG
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Telephone | 912-988-7894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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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 | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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