Organization
SAVANNAH RADIOLOGISTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE T BROUGHAN (MANAGER)
(912) 354-7089
Entity
Organization
Contact information
Practice address
1 JOHNSTON STREET, SUITE 12, SAVANNAH, GA 31405-5531
(912) 354-7089
(912) 692-8957
Mailing address
1 JOHNSTON STREET, SUITE 12, SAVANNAH, GA 31405-5531
(912) 354-7089
(912) 692-8957
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
GA
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
GA
2085R0202X
Diagnostic Radiology Physician
Primary
034456
GA
2085R0202X
Diagnostic Radiology Physician
—
GA
2085R0204X
Vascular & Interventional Radiology Physician
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
156053200
OWCP
GA
05
—
55002191A
—
GA
05
—
E05688
—
SC
Enumeration date
03/29/2006
Last updated
12/29/2010
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