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Organization

SOUTHERN ALLERGY AND ASTHMA PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACK R EADES MD (OWNER PHYSICIAN)
(912) 303-9355
Entity
Organization

Contact information

Practice address
5223 PAULSEN ST, SAVANNAH, GA 31405
(912) 303-9355
(912) 303-9356
Mailing address
5223 PAULSEN ST, SAVANNAH, GA 31405
(912) 303-9355
(912) 303-9356

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
043360
GA
207K00000X
Allergy & Immunology Physician
20053
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00751264D
GA
05
00751264E
GA
05
00751264F
GA
05
G43360
SC
Enumeration date
10/04/2006
Last updated
03/23/2016
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