Candler Ent Practice, Llc | |
5356 Reynolds Street, Suite 505, Savannah, GA 31405 | |
(912) 356-1515 | |
(912) 644-0756 |
Full Name | Candler Ent Practice, Llc |
---|---|
Type | Facility |
Speciality | Otolaryngology |
Location | 5356 Reynolds Street, Savannah, Georgia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1477969749 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
231H00000X | Audiologist | AUD003814 (Georgia) | Secondary |
207Y00000X | Otolaryngology | 025161 (Georgia) | Primary |
Provider Name | Manning M Goldsmith |
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Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1164464111 PECOS PAC ID: 4789677220 Enrollment ID: I20040408000356 |
Provider Name | James R Logan |
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Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1780626804 PECOS PAC ID: 8729067384 Enrollment ID: I20040716000574 |
Provider Name | Christina B Burns |
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Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1659472744 PECOS PAC ID: 3577532183 Enrollment ID: I20040930000349 |
Provider Name | Mary J Mcgowan |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1245331354 PECOS PAC ID: 6002873288 Enrollment ID: I20041220000608 |
Provider Name | Michael D Poole |
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Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1376561142 PECOS PAC ID: 8527012145 Enrollment ID: I20050308000133 |
Provider Name | Trisha L Dibkey |
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Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1932141322 PECOS PAC ID: 4981765633 Enrollment ID: I20090615000001 |
Provider Name | Timothy John Minton |
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Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1205086931 PECOS PAC ID: 9638221153 Enrollment ID: I20141104002733 |
Provider Name | Stephanie Ambrose |
---|---|
Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1093011249 PECOS PAC ID: 6002055563 Enrollment ID: I20160617001380 |
Provider Name | Rachel Leigh Crout |
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Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1588043004 PECOS PAC ID: 3072801174 Enrollment ID: I20170406002070 |
Provider Name | Jessica Lynn Tumolillo |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1922538669 PECOS PAC ID: 6103196852 Enrollment ID: I20170727004020 |
Provider Name | Brianna L Sapp |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659843910 PECOS PAC ID: 8729311550 Enrollment ID: I20190611002272 |
Provider Name | Tyler Keith Deblieux |
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Provider Type | Practitioner - Otolaryngology |
Provider Identifiers | NPI Number: 1295154748 PECOS PAC ID: 8022337922 Enrollment ID: I20190903001243 |
Provider Name | Leah Nicole Blackwell |
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Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1336886282 PECOS PAC ID: 5799165858 Enrollment ID: I20220707000004 |
Provider Name | Preeti Noronha |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831456441 PECOS PAC ID: 8325337934 Enrollment ID: I20240117002509 |
Provider Name | Amy Flamenbaum |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1922405992 PECOS PAC ID: 9830624030 Enrollment ID: I20241125003281 |
Mailing Address | Practice Location Address |
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Candler Ent Practice, Llc 836 E. 65th Street, Suite 22, Savannah, GA 31405 Ph: (912) 819-7878 | Candler Ent Practice, Llc 5356 Reynolds Street, Suite 505, Savannah, GA 31405 Ph: (912) 356-1515 |