# SOUTHEASTERN OB/GYN CENTER LLC

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

## Provider details

- **NPI number:** 1346534831
- **Authorized official:** DR. MICHAEL J JACKSON M.D. (OWNER)
- **Authorized official phone:** (912) 355-1111

## Contact information

- **Practice address:** 5311 PAULSEN ST, SAVANNAH, GA 31405-4800
- **Practice address phone:** (912) 355-1111
- **Practice address fax:** (912) 352-7136
- **Mailing address:** 5311 PAULSEN ST, SAVANNAH, GA 31405-4800
- **Mailing address phone:** (912) 355-1111
- **Mailing address fax:** (912) 352-7136

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 038019 | GA | Yes |

## Other

- **Enumeration date:** 06/02/2011
- **Last updated:** 03/07/2023