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General NPI Number Information
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NPI Number | 1699770446
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Entity Type | Individual
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Provider Name | JEREMY E LONDON MD
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Gender | Male
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 11700 MERCY BLVD. PLAZA D SUITE A
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City | SAVANNAH
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State | GA
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Zip | 31419
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Country | US
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Telephone | 912-819-0500
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Fax | 912-819-0501
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Provider Business Mailing Address
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Address Line | 602 E 72ND ST
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City | SAVANNAH
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State | GA
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Zip | 31405-4913
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Country | US
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Telephone | 912-819-7878
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Fax | 912-819-7850
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 050403
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 050403
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 050403
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License Number State | GA
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