Organization
MPPG, INC.
Active
Other names
Memorial Health Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN J. MADDOX (PROVIDER ENROLLMENT COORDINATOR)
(912) 350-9335
Entity
Organization
Contact information
Practice address
1107 EAST 66TH STREET, SAVANNAH, GA 31404
(912) 350-8404
(912) 350-8067
Mailing address
PO BOX 102032, ATLANTA, GA 30368-2032
(912) 350-8404
(912) 350-8067
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/08/2006
Last updated
06/01/2011
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