Provider Demographics
NPI:1033154489
Name:RADIOLOGY ASSOCIATES OF SAVANNAH, PC
Entity Type:Organization
Organization Name:RADIOLOGY ASSOCIATES OF SAVANNAH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:C
Authorized Official - Last Name:FERRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-355-8188
Mailing Address - Street 1:PO BOX 16118
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-2818
Mailing Address - Country:US
Mailing Address - Phone:912-352-9729
Mailing Address - Fax:912-356-6967
Practice Address - Street 1:1934 E MONTGOMERY XRD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-5037
Practice Address - Country:US
Practice Address - Phone:912-352-9729
Practice Address - Fax:912-356-6967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA621111261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA300019627AMedicaid