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Organization

TATTNALL HOSPITAL COMPANY LLC

Active
Other names
Optim Neurosurgery Macon
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID ALEX VILLA (CEO)
(912) 629-7797
Entity
Organization

Contact information

Practice address
121 N CREST BLVD, MACON, GA 31210-1845
(478) 841-9333
Mailing address
440 MALL BLVD STE C, SAVANNAH, GA 31406-4868
(912) 644-3340
(912) 644-5398

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
207X00000X
Orthopaedic Surgery Physician
208100000X
Physical Medicine & Rehabilitation Physician
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
208600000X
Surgery Physician
208VP0000X
Pain Medicine Physician

Other

Enumeration date
09/25/2017
Last updated
01/08/2026
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