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General NPI Number Information
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NPI Number | 1659690469
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Entity Type | Individual
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Provider Name | JEFFREY HARRIS GOLDBERG M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 210 E DERENNE AVE
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City | SAVANNAH
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State | GA
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Zip | 31405-6736
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Country | US
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Telephone | 912-644-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 210 EAST DERENNE AVE
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City | SAVANNAH
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State | GA
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Zip | 31405
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Country | US
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Telephone | 912-644-5300
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 075626
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | R2473
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4301107949
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 75626
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License Number State | GA
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