Advanced Pediatric Specialists LLC

Organization Active NPI Pediatrics Physician · Savannah, GA

NPI 1073046397 · NPPES record last updated Apr 4, 2017

Key facts

NPI
1073046397
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
Legal business name
ADVANCED PEDIATRIC SPECIALISTS LLC
Practice address
5353 Reynolds St
Savannah, GA 31405-6015
Phone
(912) 819-6000
Fax
(386) 274-7801
NPI assigned
Apr 4, 2017
Organization subpart
No

Authorized official

Name
Mark Coffey, MD
Title
President
Phone
(912) 295-2133

Practitioners 278

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 278

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20170703001659 GA Part B Supplier - Clinic/Group Practice 9830468073 Receives reassigned benefits from 4 practitioners
Practice locations: Savannah, GA

National Provider Directory

Locations

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208000000X Yes

Addresses

Primary practice location

5353 Reynolds St
Savannah, GA 31405-6015

Mailing address

PO Box 12189
Daytona Beach, FL 32120-2189
Phone (386) 274-7800

Other providers in Savannah, GA

All providers in Savannah, GA · Pediatrics Physician in Georgia

Sources for this page

Verify at the official NPI Registry.