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Organization

SJC MEDICAL GROUP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DONNA J STEPHENS (CREDENTIALING COORDINATOR)
(912) 819-7878
Entity
Organization

Contact information

Practice address
527 EISENHOWER DR, SAVANNAH, GA 31406-2668
(912) 819-9100
(912) 819-9100
Mailing address
602 E 72ND ST, SAVANNAH, GA 31405-4913
(912) 819-7878
(912) 819-7850

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
207RC0000X
Cardiovascular Disease Physician
2084N0400X
Neurology Physician

Other

Enumeration date
12/19/2012
Last updated
01/23/2017
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