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General NPI Number Information
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NPI Number | 1457183311
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Entity Type | Organization
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Legal Business Name | TATTNALL HOSPITAL COMPANY, LLC
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Dates
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Enumeration Date | 08/19/2024
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 104 CHARLES ANDREW DR UNIT 112
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City | VIDALIA
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State | GA
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Zip | 30474-7241
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Country | US
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Telephone | 912-557-1330
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Fax | 833-973-0972
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Provider Business Mailing Address
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Address Line | 440 MALL BLVD STE C
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City | SAVANNAH
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State | GA
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Zip | 31406-4868
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Country | US
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Telephone | 912-644-3340
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Fax | 912-644-5398
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Authorized Official
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Title or Position | CEO
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Name | DAVID ALEX VILLA
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Credential |
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Telephone | 706-468-7765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine 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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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