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SOUTHERN ALLERGY AND ASTHMA PC NPI 1467547281


NPI Information

NPI: 1467547281
Provider Name: SOUTHERN ALLERGY AND ASTHMA PC
Classification: Allergy & Immunology - 207K00000X
Entity Type: Organization

CLIA Number: 11D2125704

Address:
5223 PAULSEN ST
SAVANNAH, GA
ZIP 31405
Phone: (912) 303-9355
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SOUTHERN ALLERGY AND ASTHMA PC is an allergy immunology in Savannah, GA. The provider is an allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. SOUTHERN ALLERGY AND ASTHMA PC NPI is 1467547281. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5223 PAULSEN ST
SAVANNAH, GA
ZIP 31405
Phone: (912) 303-9355
Fax: (912) 303-9356

The provider's authorized official is Jack R Eades .
The authorized official title is Owner Physician and has the following contact phone number (912) 303-9355.

The CLIA number assigned to this NPI record is 11D2125704 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/4/2006 and was last updated on 3/23/2016.


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
1207K00000XAllergy & Immunology20053SOUTH CAROLINANo
2207K00000XAllergy & Immunology043360GEORGIAYes

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
1F756890281MEDICARE PINSOUTH CAROLINA
200751264FMEDICAIDGEORGIA
303BDBPKMEDICARE PINGEORGIA
4F75689MEDICARE UPIN
500751264EMEDICAIDGEORGIA
6G43360MEDICAIDSOUTH CAROLINA
700751264DMEDICAIDGEORGIA

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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