OrganizationActive
Southeast Ent & Facial Plastic Surgeyr, PC
NPI 1912288135 · Otolaryngology/Facial Plastic Surgery Physician · Pooler, GA
Provider details
- NPI number
- 1912288135
- Entity type
- Organization
- Primary specialty
- Otolaryngology/Facial Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Robert Johnson, Owner(912) 330-5030
- License
- 035071 (GA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1000 Towne Center Blvd
Suite 501
Pooler, GA 31322-4052
Phone: (912) 330-5030
Fax: (912) 330-5033
Approximate (ZIP-level) locationGet directions
Mailing address
1000 Towne Center Blvd
Pooler, GA 31322-4052
Registry dates
- Enumerated
- 2011-09-01
- Last updated
- 2011-09-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.