Provider Demographics
NPI:1295591071
Name:SAV34SC01 LLC
Entity type:Organization
Organization Name:SAV34SC01 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGMR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:803-800-0413
Mailing Address - Street 1:4540 SOUTHSIDE BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-5488
Mailing Address - Country:US
Mailing Address - Phone:904-503-1065
Mailing Address - Fax:904-374-6075
Practice Address - Street 1:413 W MONTGOMERY CROSS RD STE 406
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3396
Practice Address - Country:US
Practice Address - Phone:912-358-0565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty