SOUTH GEORGIA VEIN CENTERS, LLC (NPI# 1669405452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669405452 |
| Entity Type | Organization |
| Organization Name | SOUTH GEORGIA VEIN CENTERS, LLC |
| Practice Address |
3338 Country Club Rd # M Valdosta GA 31605-1044 |
| Practice Telephone | 2292599666 |
| Practice Fax Number | 2292530064 |
| Mailing Telephone | 2292599666 |
| Mailing Fax Number | 2292530064 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GREGORY D MARTIN (PRESIDENT) |
| Authorized Official Telephone | 2292599666 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
3338 COUNTRY CLUB RD # M |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31605-1044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484718 | Mckenna Kristine Bachmann | Specialist/Technologist | Moody Air Force Base, Valdosta, GA 31605 | 2020-07-14 |
| 1376056366 | Michael Brent Robinson Sr. | Contractor | 3863 Camellia Dr., Valdosta, GA 31605 | 2017-11-13 |
| 1679013452 | Baptist Specialty Physicians Inc | Pediatrics | 3301 N Oak St Ext, Valdosta, GA 31605 | 2017-02-28 |
| 1649683541 | Dustin Ross Kilby | Dentist | 2704 Oak Center Dr, Valdosta, GA 31605 | 2014-06-09 |
| 1659643286 | Brittnaey Nicole Freeman | Behavioral Analyst | 3982 Karaline Cir, Valdosta, GA 31605 | 2012-01-27 |
| 1780970335 | Laura Christen Cribbs | Counselor | 3312-d N Oak Street Ext, Valdosta, GA 31605 | 2011-06-22 |
| 1992090633 | Mary Katelyn Harper | Pharmacist | 3200 North Oak Street, Valdosta, GA 31605 | 2011-06-10 |
| 1053532937 | Robert Mark Pearson | Dentist | 3227 N. Oak St. Ext., Valdosta, GA 31605 | 2007-05-01 |
| 1083838650 | Am Sleep Diagnostics and Research Center | Clinic/Center | 3334 Greyatone Way, Valdosta, GA 31605 | 2007-04-12 |
| 1831236181 | William Ashley Moorman | Dentist | Advanced Dental Care, 3211 Wildwood Plantation Drive, Valdosta, GA 31605 | 2007-01-30 |
| Find all providers in zip 31605 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215976105 | Maurice M Solis | Surgery | 2409 N Patterson St, Suite 230, Valdosta, GA 31602-2512 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285241265 | Jennifer Ann Hales | Surgery | 11090 Mcauley, Suite 100 2a, Savannah, GA 31419 | 2020-09-24 |
| 1902423387 | Center for Vein Restoration Ga Corp | Surgery | 1100 Johnson Fy Rd Ne Ste 165, Atlanta, GA 30342-1795 | 2020-07-01 |
| 1487133278 | Usa Vascular Center of Decatur LLC | Surgery | 495 Winn Way Ste 230, Decatur, GA 30030-1736 | 2018-08-13 |
| 1841789914 | Milner Vein and Vascular LLC | Surgery | 5700 Hillandale Dr Ste 150, Lithonia, GA 30058 | 2018-05-04 |
| 1023517505 | Antioch Vascular Center, LLC | Surgery | 9104 Middleground Road, Suite 2, Savannah, GA 31406 | 2018-02-09 |
| 1689012205 | Daniel Joseph Badia | Surgery | 601 Professional Dr Ste A220, Lawrenceville, GA 30046-7698 | 2013-06-05 |
| 1740507425 | Christopher Ray Ramos | Surgery | 1365 Clifton Road Ne, Building A, Room A2200, Atlanta, GA 30322 | 2010-04-21 |
| 1184879678 | Rockdale Vascular and Thoracic Surgery, LLC | Surgery | 1368c Wellbrook Cir Ne, Conyers, GA 30012-3872 | 2008-11-25 |
| 1528218393 | Vladimir Zahradnik | Surgery | 380 Hospital Dr Bldg A Ste 320, Macon, GA 31217 | 2008-09-29 |
| 1487819132 | Yazan Duwayri | Surgery | Division of Vascular Surgery Emory Clinic Bldg A, 1365 Clifton Road Ne. 3rd Floor, Atlanta, GA 30322-0001 | 2008-07-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.