| Savannah Neuropsychology Inc | |
|
450 Mall Blvd Ste E Savannah GA 31406-4864 | |
| (912) 349-4055 | |
| (912) 244-6500 |
| Full Name | Savannah Neuropsychology Inc |
|---|---|
| Speciality | Psychologist |
| Location | 450 Mall Blvd Ste E, Savannah, Georgia |
| Authorized Official Name and Position | Thomas K Pedigo (OWNER/CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 9126565503 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Savannah Neuropsychology Inc 400 Mall Blvd Ste W Savannah GA 31406-4861 Ph: (912) 349-4055 | Savannah Neuropsychology Inc 450 Mall Blvd Ste E Savannah GA 31406-4864 Ph: (912) 349-4055 |
| NPI Number | 1699450064 |
|---|---|
| Provider Enumeration Date | 06/21/2023 |
| Last Update Date | 12/17/2024 |
| Certification Date | 12/17/2024 |
| Medicare PECOS PAC ID | 9436510690 |
|---|---|
| Medicare Enrollment ID | O20230803002895 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699450064 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Thomas K Pedigo |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1164559738 PECOS PAC ID: 9234466848 Enrollment ID: I20230913003091 |
| Provider Name | Orisbel Fernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356997431 PECOS PAC ID: 9436684925 Enrollment ID: I20241120002957 |
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