Organization Name: | SOUTHERN SURGICAL PC |
NPI Number: | 1700905593 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM (BILL) H MOSES (OWNER) |
Mailing Address: | 2406 Bellevue Rd #11 Erin Office Park Dublin |
State: | GA US |
Postal Code: | 310212842 |
Phone Number: | 4782752454 |
Fax Number: | 4782750991 |
NPI Enumeration Date: | 03/29/2007 |
NPI Last Update Date: | 08/01/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |