# MEMORIAL PHYSICIANS GROUP INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013377530
- **Authorized official:** SEBRENA HOLMES GIBSON (PROVIDER ENROLLMENT COORDINATOR)
- **Authorized official phone:** (912) 350-9335

## Contact information

- **Practice address:** 4731 WATERS AVE, SAVANNAH, GA 31404-6219
- **Practice address phone:** (912) 350-4905
- **Practice address fax:** (912) 350-4955
- **Mailing address:** 4731 WATERS AVE, SAVANNAH, GA 31404-6219
- **Mailing address phone:** (912) 350-4905
- **Mailing address fax:** (912) 350-4955

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2080P0203X | Pediatric Critical Care Medicine Physician | — | NULL | — |
| 2080P0203X | Pediatric Critical Care Medicine Physician | — | — | — |
| 2080P0205X | Pediatric Endocrinology Physician | — | NULL | — |
| 2080P0205X | Pediatric Endocrinology Physician | — | — | — |
| 2080P0207X | Pediatric Hematology & Oncology Physician | — | NULL | — |
| 2080P0207X | Pediatric Hematology & Oncology Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | NULL | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | — | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | — |

## Other

- **Enumeration date:** 02/25/2016
- **Last updated:** 02/25/2016