=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568078483
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHAEL W SAVELLE JR. FNP-C
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2020
-----------------------------------------------------
Last Update Date | 10/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 HIGHWAY 19 W SUITE 201
-----------------------------------------------------
City | BARNESVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30204
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-358-3284
-----------------------------------------------------
Fax | 770-872-5041
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 HIGHWAY 19 W SUITE 201
-----------------------------------------------------
City | BARNESVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30204
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-358-3284
-----------------------------------------------------
Fax | 770-872-5041
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | RN274917
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------