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SOUTH GEORGIA SURGICAL CLINIC PC NPI 1770544694


NPI Information

NPI: 1770544694
Provider Name: SOUTH GEORGIA SURGICAL CLINIC PC

Doing Business As: SOUTH GEORGIA SURGICAL CLINIC PC

Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
1007 GREENFIELD DR
TIFTON, GA
ZIP 31794
Phone: (229) 382-9733
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SOUTH GEORGIA SURGICAL CLINIC PC is a vascular surgery surgery in Tifton, GA. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. SOUTH GEORGIA SURGICAL CLINIC PC NPI is 1770544694. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As South Georgia Surgical Clinic Pc.

The provider's business location address is:

1007 GREENFIELD DR
TIFTON, GA
ZIP 31794-795
Phone: (229) 382-9733
Fax: (229) 387-6161

The provider's authorized official is Joel M Johnson .
The authorized official title is President and has the following contact phone number (229) 382-9733.

The enumeration date for this NPI number is 3/30/2006 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0129XSurgeryVascular SurgeryGEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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