OrganizationActive
Provident Health Services, Inc.
NPI 1225199383 · Surgical Oncology Physician · Savannah, GA
Provider details
- NPI number
- 1225199383
- Entity type
- Organization
- Primary specialty
- Surgical Oncology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Robin Maddox, Provider Enrollment Coordinator(912) 350-9335
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Surgery Physician208600000X
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4700 Waters Ave
Savannah, GA 31404-6220
Phone: (912) 350-2299
Fax: (912) 350-2298
Street-level locationGet directions
Mailing address
Po Box 933213
Atlanta, GA 31193
Other names (DBA / former)
- Doing business as
- Aci Surgical Associates
Registry dates
- Enumerated
- 2006-12-13
- Last updated
- 2008-11-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.