Basic Information
| Provider Information | |||||||||
| NPI: | 1053868083 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAVANNAH RESPIRATORY AND ALLERGY ASSOCIATES, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 MULBERRY BLUFF DR | ||||||||
| Address2: | |||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314063270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9125475591 | ||||||||
| FaxNumber: | 9125275279 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 MULBERRY BLUFF DR | ||||||||
| Address2: | |||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314063270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9125475591 | ||||||||
| FaxNumber: | 9125275279 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2016 | ||||||||
| LastUpdateDate: | 09/07/2016 | ||||||||
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| AuthorizedOfficialLastName: | HENDRIX | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | G | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9126570466 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207KA0200X | 23459 | GA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Allergy & Immunology | Allergy | 207RP1001X | 23459 | GA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.