SOUTHEASTERN OB/GYN CENTER LLC NPI 1346534831

NPI Information

  • NPI: 1346534831
  • Provider Name: SOUTHEASTERN OB/GYN CENTER LLC
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Organization
  • CLIA Number: 11D2028834
  • Address: 5311 PAULSEN ST
    SAVANNAH, GA
    ZIP 31405
  • Phone: (912) 355-1111

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NPI Details

SOUTHEASTERN OB/GYN CENTER LLC is an obstetrics gynecology in Savannah, GA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. SOUTHEASTERN OB/GYN CENTER LLC NPI is 1346534831. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5311 PAULSEN ST
SAVANNAH, GA
ZIP 31405-800
Phone: (912) 355-1111
Fax: (912) 352-7136

The provider's authorized official is Michael J Jackson .
The authorized official title is Owner and has the following contact phone number (912) 355-1111.

The CLIA number assigned to this NPI record is 11D2028834 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/2/2011 and was last updated on 3/7/2023.

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
1207V00000XObstetrics & Gynecology038019GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100729473AMEDICAIDGEORGIA
2038019OTHERGEORGIALICENSE

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: 3/30/2025

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