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SOUTHEAST ENT & FACIAL PLASTIC SURGEYR PC NPI 1912288135


NPI Information

NPI: 1912288135
Provider Name: SOUTHEAST ENT & FACIAL PLASTIC SURGEYR, PC
Classification: Otolaryngology - 207YX0905X
Entity Type: Organization

Specialization: Otolaryngology/Facial Plastic Surgery

Address:
1000 TOWNE CENTER BLVD
SUITE 501
POOLER, GA
ZIP 31322
Phone: (912) 330-5030
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SOUTHEAST ENT & FACIAL PLASTIC SURGEYR, PC is an otolaryngology/facial plastic surgery otolaryngology in Pooler, GA. The provider is an otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. SOUTHEAST ENT & FACIAL PLASTIC SURGEYR, PC NPI is 1912288135. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1000 TOWNE CENTER BLVD
SUITE 501
POOLER, GA
ZIP 31322-052
Phone: (912) 330-5030
Fax: (912) 330-5033

The provider's authorized official is Robert E Johnson .
The authorized official title is Owner and has the following contact phone number (912) 330-5030.

The enumeration date for this NPI number is 9/1/2011 and was last updated on 9/1/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207YX0905XOtolaryngologyOtolaryngology/Facial Plastic Surgery035071GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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