Organization
MPPG, INC.
Active
Other names
University OB/GYN
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROBIN J. MADDOX (PROVIDER ENROLLMENT COORDINATOR)
(912) 350-9335
Entity
Organization
Contact information
Practice address
1101 LEXINGTON AVE, SAVANNAH, GA 31404-5502
(912) 350-9633
(912) 350-3699
Mailing address
1101 LEXINGTON AVE, SAVANNAH, GA 31404-5502
(912) 350-9633
(912) 350-3699
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GPA947
—
SC
Enumeration date
09/13/2007
Last updated
08/26/2011
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