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Organization
PATHOLOGIC DIAGNOSTIC LLC
Active
Organization
PATHOLOGIC DIAGNOSTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRISCILLA JONES (CREDENTIALING MANAGER)
(912) 925-0067
Entity
Organization
Contact information
Practice address
1261 RIBAUT ROAD, BEAUFORT, SC 29902
(843) 783-2273
Mailing address
219 W BRYAN ST STE 200, SAVANNAH, GA 31401-2542
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
—
NULL
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
246QL0900X
Laboratory Management Specialist/Technologist
Primary
—
—
Other
Enumeration date
11/03/2025
Last updated
09/08/2026
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