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Organization
MPPG, INC.
Active
Organization
MPPG, INC.
Active
Other names
Memorial Health Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN J. MADDOX (PROVIDER ENROLLMENT COORDINATOR)
(912) 350-9335
Entity
Organization
Contact information
Practice address
1107 EAST 66TH STREET, SAVANNAH, GA 31404
(912) 350-8404
(912) 350-8067
Mailing address
PO BOX 102032, ATLANTA, GA 30368-2032
(912) 350-8404
(912) 350-8067
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/08/2006
Last updated
06/01/2011
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