SOUTHEAST ENT & FACIAL PLASTIC SURGEYR, PC (NPI# 1912288135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912288135 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST ENT & FACIAL PLASTIC SURGEYR, PC |
| Practice Address |
1000 Towne Center Blvd Suite 501 Pooler GA 31322-4052 |
| Practice Telephone | 9123305030 |
| Practice Fax Number | 9123305033 |
| Mailing Telephone | 9123305030 |
| Mailing Fax Number | 9123305033 |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2011-09-01 |
| Authorized Official Name | DR. ROBERT E JOHNSON (OWNER) |
| Authorized Official Telephone | 9123305030 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
035071 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1000 TOWNE CENTER BLVD SUITE 501 |
| City | POOLER |
| State | GA |
| Zip Code | 31322-4052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154319408 | Wound Care Clinic - Esu, Inc. | Clinic/Center | 1000 Towne Center Blvd, Suite 705, Pooler, GA 31322-4052 | 2005-10-11 |
| 1891241360 | The Whole Tooth | Dentist | 1000 Towne Center Blvd, Suite 505, Pooler, GA 31322-4052 | 2016-08-25 |
| 1467815472 | Genesis Wound Care of Pooler, LLC | Durable Medical Equipment & Medical Supplies | 1000 Towne Center Blvd, Building 400, Pooler, GA 31322-4052 | 2016-03-29 |
| 1538529631 | Southern Allergy & Asthma, PC | Allergy & Immunology | 1000 Towne Center Blvd, Building 500 Suite 305, Pooler, GA 31322-4052 | 2016-03-02 |
| 1912365495 | Jana Alisa Bevill | Nurse Practitioner | 1000 Towne Center Blvd, Suite 160, Pooler, GA 31322-4052 | 2016-01-29 |
| 1376930339 | Genesis Vascular of Pooler, LLC | Internal Medicine | 1000 Towne Center Blvd, Building 400, Pooler, GA 31322-4052 | 2015-04-16 |
| 1598157364 | Matthew J. Allen, D.d.s., L.L.C. | Dentist | 1000 Towne Center Blvd, Suite 101, Pooler, GA 31322-4052 | 2015-03-03 |
| 1316338494 | Ear, Nose & Throat Associates of Savannah, PC | Otolaryngology | 1000 Towne Center Blvd, Ste 200, Pooler, GA 31322-4052 | 2015-02-11 |
| 1598153900 | Chatham Orthopaedic Associates, Pa | Orthopaedic Surgery | 1000 Towne Center Blvd, Suite 602, Pooler, GA 31322-4052 | 2015-01-07 |
| 1962836106 | Catherine E Hamlin | Dentist | 1000 Towne Center Blvd, Pooler, GA 31322-4052 | 2013-08-23 |
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|---|---|---|---|---|
| 1427518745 | Quinate Pharmacy LLC | Pharmacy | 1557 Pooler Pkwy, Suite 400, Pooler, GA 31322 | 2019-03-22 |
| 1396202495 | Rucker Holdings | Durable Medical Equipment & Medical Supplies | 210 Grand Central Blvd, Pooler, GA 31322 | 2019-02-25 |
| 1306301841 | Altamaha Dme, Inc | Durable Medical Equipment & Medical Supplies | 1557 Pooler Parkway, Suite 300, Pooler, GA 31322 | 2019-02-08 |
| 1750859351 | Bombery Chiropractic LLC | Chiropractor | 122 Canal St. Ste 109, Pooler, GA 31322 | 2018-11-13 |
| 1407347891 | Georgia Dental Professionals, PC | Dentist | 2140 Pooler Pkwy, Pooler, GA 31322 | 2018-05-22 |
| 1730685439 | Monali Patel | Optometrist | 276 Pooler Pkwy Ste B, Pooler, GA 31322 | 2018-04-02 |
| 1144747023 | Publix Super Markers, Inc | Durable Medical Equipment & Medical Supplies | 101 Blue Moon Crossing, Pooler, GA 31322 | 2017-08-23 |
| 1063932408 | The Range Physical Therapy, LLC | Clinic/Center | 10801 County Line Rd, Madison, AL 31322 | 2017-06-27 |
| 1285154427 | Pooler Physical Therapy LLC | Clinic/Center | 101 Shepherd Way, Pooler, GA 31322 | 2017-06-20 |
| 1578009130 | Georgia Cvs Pharmacy L.l.c | Durable Medical Equipment & Medical Supplies | 500 Pooler Pkwy, Pooler, GA 31322 | 2017-01-06 |
| Find all providers in zip 31322 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942431408 | Joseph H. Bee | Otolaryngology | 3025 Shrine Road, Suite 480, Brunswick, GA 31520-4722 | 2009-08-01 |
| 1821164500 | Booker Terry Seymour IIi | Otolaryngology | 3280 Howell Mill Rd, Ste 200, Atlanta, GA 30327 | 2006-11-27 |
| 1245305879 | Piedmont Ear Nose &throat Associates PC | Otolaryngology | 1720 Peachtree Street, Suite 200, Atlanta, GA 30309-1605 | 2006-11-21 |
| 1356428700 | Neil A Persaud | Otolaryngology | 6130 Prestley Mill Rd Ste C, Douglasville, GA 30134-2288 | 2006-11-01 |
| 1609959725 | Robert David Marcus | Otolaryngology | 8065 Innisbrook Ct, Columbus, GA 31909-2088 | 2006-10-23 |
| 1982786810 | Ramon S. Franco | Otolaryngology | 700 Galleria Pkwy Se, Suite 350, Atlanta, GA 30339-5943 | 2006-10-19 |
| 1023198660 | Donald Patrick Dennis | Otolaryngology | 3193 Howell Mill Rd, #215, Atlanta, GA 30327 | 2006-10-17 |
| 1073596193 | Douglas Christian Miller | Otolaryngology | 2151 W Spring St Ste B120, Monroe, GA 30655-3210 | 2005-11-22 |
| 1265425912 | Rick Lockhart | Otolaryngology | 111 Fieldstone Dr, Suite 102, Milledgeville, GA 31061-7106 | 2005-08-29 |
| 1922000959 | David S Oliver | Otolaryngology | 322 Commercial Dr Ste 2, Savannah, GA 31406 | 2005-08-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.