Provider Demographics
NPI:1104956184
Name:SAVANNAH SURGERY CENTER, LLP
Entity type:Organization
Organization Name:SAVANNAH SURGERY CENTER, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HENLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-354-8331
Mailing Address - Street 1:1 MEDICAL ARTS CTR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4414
Mailing Address - Country:US
Mailing Address - Phone:912-354-2232
Mailing Address - Fax:912-354-6656
Practice Address - Street 1:5102 PAULSEN ST
Practice Address - Street 2:BUILDING 2
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4601
Practice Address - Country:US
Practice Address - Phone:912-354-8331
Practice Address - Fax:912-352-9782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP3557Medicare ID - Type UnspecifiedGROUP MEDICARE ID