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General NPI Number Information
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NPI Number | 1528918299
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Entity Type | Individual
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Provider Name | JASON BOSTIC
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Gender | Male
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 1 JOHNSTON ST STE 1
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City | SAVANNAH
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State | GA
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Zip | 31405-5532
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Country | US
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Telephone | 573-337-0519
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Fax |
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Provider Business Mailing Address
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Address Line | 25 LAKE DR
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City | MIDWAY
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State | GA
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Zip | 31320-3613
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Country | US
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Telephone | 573-337-0519
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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