Organization
PSYCHIATRIC GROUP OF THE COASTAL EMPIRE, INC.
Active
Organization
PSYCHIATRIC GROUP OF THE COASTAL EMPIRE, INC.
Active
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) 350-4905
(912) 350-4955
Mailing address
PO BOX 931979, ATLANTA, GA 31193-1968
(912) 350-4905
(912) 350-4955
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3000032168A
—
GA
Enumeration date
10/13/2006
Last updated
01/15/2008
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