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PROVIDENT HEALTH SURGICAL ASSOCIATES INC. NPI 1316195373


NPI Information

NPI: 1316195373
Provider Name: PROVIDENT HEALTH SURGICAL ASSOCIATES, INC.

Doing Business As: ACI SURGICAL ASSOCIATES

Classification: Surgery - 2086X0206X
Entity Type: Organization

Specialization: Surgical Oncology

Address:
4700 WATERS AVE
SAVANNAH, GA
ZIP 31404
Phone: (912) 350-2299
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PROVIDENT HEALTH SURGICAL ASSOCIATES, INC. is a surgical oncology surgery in Savannah, GA. The provider is a surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. PROVIDENT HEALTH SURGICAL ASSOCIATES, INC. NPI is 1316195373. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Aci Surgical Associates.

The provider's business location address is:

4700 WATERS AVE
SAVANNAH, GA
ZIP 31404-220
Phone: (912) 350-2299
Fax: (912) 350-2298

The provider's authorized official is Robin J. Maddox .
The authorized official title is Provider Enrollment Coordinator and has the following contact phone number (912) 350-9335.

The enumeration date for this NPI number is 9/3/2008 and was last updated on 5/3/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207VX0201XObstetrics & GynecologyGynecologic OncologyNo
2207Y00000XOtolaryngologyNo
32086S0102XSurgerySurgical Critical CareNo
4208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)No
52086X0206XSurgerySurgical OncologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DO4195OTHERGEORGIARR MEDICARE
2DO4198OTHERSOUTH CAROLINARR MEDICARE
3511G701119MEDICARE PINGEORGIA
49141MEDICARE PINSOUTH CAROLINA
5824884292AMEDICAIDGEORGIA
6GPA978MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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