Provident Health Services, Inc.

NPI #1225199383 in Savannah, Georgia

Provider Information

NPI Number
1225199383
Entity Type
Organization
Organization Name
Provident Health Services, Inc.
Primary Specialty
Surgery - Surgical Oncology
Enumeration Date
Dec 13, 2006
Last Updated
Nov 11, 2008

Practice Location

Address
4700 WATERS AVE
State
Georgia
ZIP Code
31404-6220
Phone
(912) 350-2299

Authorized Official

Name
ROBIN J. MADDOX
Title
PROVIDER ENROLLMENT COORDINATOR
Phone
(912) 350-9335

Specialties & Taxonomy Codes

Specialty
Surgery
Surgery - Surgical OncologySurgical Oncology

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