Organization
COSSIO PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA FITTON (OFFICE MANAGER)
(912) 354-3130
Entity
Organization
Contact information
Practice address
334 STEPHENSON AVE, SAVANNAH, GA 31405-5929
(912) 354-3130
(912) 354-5860
Mailing address
334 STEPHENSON AVE, SAVANNAH, GA 31405-5929
(912) 354-3130
(912) 354-5860
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036357
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000532727A
—
GA
05
—
000872638A
—
GA
05
—
000874244A
—
GA
01
—
1811922693
INDIVIDUAL NATIONAL PROVIDER #
GA
01
—
1861423295
INDIDIVUAL NATIONAL PROVIDER #
GA
01
—
1912938366
INDIVIDUAL NATIONAL PROVIDER #
GA
Enumeration date
07/10/2008
Last updated
10/18/2017
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