Individual
LAUREN SACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16915 HIGHWAY 67 STE A, STATESBORO, GA 30458-5819
(912) 681-2500
(912) 681-2025
Mailing address
210 E DERENNE AVE, SAVANNAH, GA 31405-6736
(912) 644-5300
(912) 644-5241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6383
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003134896C
—
GA
05
—
003134896D
—
GA
05
—
003134896E
—
GA
Enumeration date
03/22/2012
Last updated
03/17/2018
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