Southeast Georgia Neurological Centers, PC

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

063231 Issued in GA

Legal business name

SOUTHEAST GEORGIA NEUROLOGICAL CENTERS, PC

Practice address

1 Oglethorpe Professional Blvd
Suite 202
Savannah, GA 31406-4883

Phone

(912) 354-7553

Fax

(912) 354-7559

NPI assigned

Nov 4, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jerry Kimble Williams Jr., M.D.

Title

President/Ceo

Phone

(912) 308-0444

Specialties & licenses 1

Addresses

Other names 1

• Chatham Neurology Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257292800000",
    "number": "1831426360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15694",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314162394",
            "telephone_number": "912-354-7553",
            "fax_number": "912-354-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OGLETHORPE PROFESSIONAL BLVD",
            "address_2": "SUITE 202",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064883",
            "telephone_number": "912-354-7553",
            "fax_number": "912-354-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST GEORGIA NEUROLOGICAL CENTERS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-04",
        "last_updated": "2009-11-04",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "KIMBLE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "912-308-0444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "GA",
            "license": "063231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chatham Neurology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Savannah, GA
• Neurology with Special Qualifications in Child Neurology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.