Basic Information
Provider Information
NPI: 1558970657
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YOUNT
FirstName: JULIA
MiddleName: GAINEY
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5714 COLONIAL DR
Address2:  
City: SAVANNAH
State: GA
PostalCode: 314062139
CountryCode: US
TelephoneNumber: 7706569465
FaxNumber:  
Practice Location
Address1: 5353 REYNOLDS ST
Address2:  
City: SAVANNAH
State: GA
PostalCode: 314056015
CountryCode: US
TelephoneNumber: 9128196000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/24/2020
LastUpdateDate: 01/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/03/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367H00000X  Y Physician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant 

No ID Information.


Home