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.
Organization
PROVIDENT HEALTH SERVICES, INC.
Active
Organization
PROVIDENT HEALTH SERVICES, INC.
Active
Other names
Clinical Genetics Associates
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN J. MADDOX (PROVIDER ENROLLMENT COORDINATOR)
(912) 350-9335
Entity
Organization
Contact information
Practice address
4700 WATERS AVE, SAVANNAH, GA 31404-6220
(912) 350-8490
(912) 350-8199
Mailing address
PO BOX 933213, ATLANTA, GA 31193-3213
(912) 350-8490
(912) 350-8199
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
—
NULL
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
—
—
207SG0203X
Clinical Molecular Genetics Physician
—
NULL
207SG0203X
Clinical Molecular Genetics Physician
—
—
Other
Enumeration date
12/13/2006
Last updated
11/12/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers