Organization
EAR, NOSE, & THROAT ASSOCIATES OF SAVANNAH, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY LAYNE (OFFICE MANAGER)
(912) 629-4535
Entity
Organization
Contact information
Practice address
16741 HIGHWAY 67 SOUTH, SUITE G, STATESBORO, GA 30458
(912) 351-3030
(912) 351-3039
Mailing address
5201 FREDERICK STREET, SAVANNAH, GA 31405-4501
(912) 351-3030
(912) 351-3039
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
008102 B 621111
GA
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300034510A
MEDICAID PAYEE: SITE 1
GA
01
—
300034510K
MEDICAID PAYEE: SITE 2
GA
Enumeration date
11/19/2008
Last updated
04/01/2010
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