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Organization
MPPG, INC.
Active
Organization
MPPG, INC.
Active
Other names
Surgical Specialists of Savannah
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN J. MADDOX (PROVIDER ENROLLMENT COORDINATOR)
(912) 350-9335
Entity
Organization
Contact information
Practice address
200 MAPLE DRIVE, VIDALIA, GA 30474
(912) 537-9851
(912) 537-9843
Mailing address
PO BOX 102032, ATLANTA, GA 30368-2032
(912) 537-9851
(912) 537-9843
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
Primary
—
NULL
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Enumeration date
12/01/2006
Last updated
08/15/2012
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