Provider Demographics
NPI:1699450064
Name:SAVANNAH NEUROPSYCHOLOGY INC
Entity type:Organization
Organization Name:SAVANNAH NEUROPSYCHOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:K
Authorized Official - Last Name:PEDIGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-656-5503
Mailing Address - Street 1:400 MALL BLVD STE W
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-4861
Mailing Address - Country:US
Mailing Address - Phone:912-349-4055
Mailing Address - Fax:912-600-1969
Practice Address - Street 1:450 MALL BLVD STE E
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-4864
Practice Address - Country:US
Practice Address - Phone:912-349-4055
Practice Address - Fax:912-244-6500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty