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General NPI Number Information
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NPI Number | 1538147863
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Entity Type | Organization
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Legal Business Name | SAVANNAH BONE & JOINT SP
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Dates
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Enumeration Date | 01/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 340 MAIN ST
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City | SAVANNAH
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State | TN
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Zip | 38372
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Country | US
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Telephone | 731-925-9909
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Fax | 731-925-3323
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Provider Business Mailing Address
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Address Line | 340 MAIN ST
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City | SAVANNAH
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State | TN
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Zip | 38372
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Country | US
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Telephone | 731-925-9909
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Fax | 731-925-3323
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Authorized Official
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Title or Position | PRESIDENT
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Name | BARRY J HENNESSEY
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Credential | DO
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Telephone | 731-925-9909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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