Provider Demographics
NPI:1114167707
Name:KIDNEY SPECIALISTS OF SOUTHEAST GEORGIA, INC
Entity Type:Organization
Organization Name:KIDNEY SPECIALISTS OF SOUTHEAST GEORGIA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAXTON
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:912-356-5643
Mailing Address - Street 1:500 E 66TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4339
Mailing Address - Country:US
Mailing Address - Phone:912-356-5643
Mailing Address - Fax:912-356-9712
Practice Address - Street 1:1010 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 210
Practice Address - City:HARDEEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29927-3447
Practice Address - Country:US
Practice Address - Phone:912-356-5643
Practice Address - Fax:912-356-9712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty