# PREMISE HEALTH OF GEORGIA MEDICAL, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Employees' Family Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407910169
- **Authorized official:** JON LEIZMAN M.D. (PRESIDENT)
- **Authorized official phone:** (216) 479-9603

## Contact information

- **Practice address:** 836 EAST 65TH STREET, 4 MEDICAL ARTS, SAVANNAH, GA 31405-4491
- **Practice address phone:** (912) 351-0057
- **Practice address fax:** (912) 351-0074
- **Mailing address:** 16906 COLLECTION CENTER DR, CHICAGO, IL 60693-0169
- **Mailing address phone:** (877) 865-9013
- **Mailing address fax:** (217) 709-2345

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/20/2006
- **Last updated:** 08/24/2022