Provider Demographics
NPI:1851900575
Name:JONES, SAVANNAH (PA-C)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:
Last Name:JONES
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:
Other - Last Name:ROUGHTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1214 W WOOSTER ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-3600
Mailing Address - Country:US
Mailing Address - Phone:419-485-7070
Mailing Address - Fax:
Practice Address - Street 1:4405 N HOLLAND SYLVANIA RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3529
Practice Address - Country:US
Practice Address - Phone:567-803-0426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601010575363A00000X
OH50.006941RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant