Organization
ENDOSCOPY CENTER OF COASTAL GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY L GILLIAM (BILLING MANAGER)
(912) 354-9447
Entity
Organization
Contact information
Practice address
519 STEPHENSON AVE, SAVANNAH, GA 31405-5969
(912) 354-9447
(912) 303-9246
Mailing address
519 STEPHENSON AVE, SAVANNAH, GA 31405-5969
(912) 354-9447
(912) 303-9246
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
86172S
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000969702A
—
GA
Enumeration date
08/28/2006
Last updated
03/09/2009
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