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General NPI Number Information
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NPI Number | 1437953668
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Entity Type | Organization
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Legal Business Name | STAR ORTHOPEDICS AND SPINE OF SAVANNAH LLC.
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Dates
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Enumeration Date | 04/04/2025
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 2 PARK OF COMMERCE BLVD STE E
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City | SAVANNAH
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State | GA
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Zip | 31405-7410
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Country | US
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Telephone | 561-699-6373
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 W OAK ST STE A
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City | KISSIMMEE
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State | FL
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Zip | 34741-4113
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Country | US
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Telephone | 561-699-6373
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Fax |
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Authorized Official
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Title or Position | COO
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Name | HILLARY KOERNER
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Credential |
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Telephone | 561-699-6373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery 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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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