Individual
JASON C STILLWAGON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4700 WATERS AVE, SAVANNAH, GA 31404-6220
(912) 350-3849
Mailing address
4700 WATERS AVE, SAVANNAH, GA 31404-6220
(912) 350-3849
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
53181
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10064509
AMERIGROUP
GA
01
—
603351017A
PEACHSTATE
GA
05
—
603351017A
—
GA
01
—
851205
BLUE CROSS BLUE SHIELD
GA
05
—
G35774
—
SC
05
—
G53181
—
SC
01
—
N365315
NON PAR WELLCARE
GA
Enumeration date
05/20/2006
Last updated
06/12/2024
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