Individual
DR. ANDREW PHILLIP STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
710 CENTER ST, COLUMBUS, GA 31901-1527
(706) 571-1311
Mailing address
4700 WATERS AVE, SAVANNAH, GA 31404-6220
(912) 350-8180
(912) 350-5697
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
071886
GA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
71886
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003146322A
—
GA
01
—
P01335436
RAILROAD MEDICARE
GA
Enumeration date
05/21/2008
Last updated
04/28/2025
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