Organization
THE NEUROLOGICAL CENTER OF EAST GEORGIA PC
Active
Other names
Statesboro Neurological Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GINA MICHELE TAORMINA MBA MHA (ADMINISTRATOR)
(912) 871-8900
Entity
Organization
Contact information
Practice address
1601 FAIR ROAD, SUITE 400 COTTON RIDGE MEDICAL PLAZA, STATESBORO, GA 30458-1699
(912) 871-8900
(912) 871-8901
Mailing address
1601 FAIR ROAD, SUITE 400, STATESBORO, GA 30458-1699
(912) 871-8900
(912) 871-8901
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
040258
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52676473001
BCBS
GA
01
—
GPA675
MEDICAID
SC
Enumeration date
08/17/2006
Last updated
08/22/2020
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