Organization
PEDS HEALTH
Active
Other names
Ericka Russell-Petty
Organization subpart
No
Provider details
NPI number
Authorized official
ERICKA RUSSELL-PETTY M.D. (PHYSICIANN)
(912) 777-5490
Entity
Organization
Contact information
Practice address
3710 WATERS AVE, SAVANNAH, GA 31404-6209
(921) 777-5490
(912) 777-5491
Mailing address
5710 OGEECHEE RD, STE 200 BOX 283, SAVANNAH, GA 31405-9515
(912) 777-5490
(912) 777-5471
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
047258
GA
Other
Enumeration date
08/30/2016
Last updated
08/30/2016
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