Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 11893 | GA |
NPI | 1639795529 |
---|---|
Provider Name | Dr. Savannah Stockton |
First Address | Augusta, GA 30909-2416 |
Second Address | Augusta, GA 30912-0004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2020 |
Last Update Date | 17/06/2020 |