Organization
MPPG, INC.
Active
Other names
ACI Surgical Associates
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
4700 WATERS AVE, SAVANNAH, GA 31404-6220
(912) 350-2299
(912) 350-2298
Mailing address
4700 WATERS AVE, SAVANNAH, GA 31404-6220
(912) 350-2299
(912) 350-2298
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208600000X
Surgery Physician
—
—
2086X0206X
Surgical Oncology Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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