Carrollton Surgical Group, P. a.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

CARROLLTON SURGICAL GROUP, P. A.

Practice address

209 Main St S
Wedowee, AL 36278-5139

Phone

(770) 834-3336

Fax

(770) 832-2331

NPI assigned

Jun 26, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jan M Zeis

Title

Practice Administrator

Phone

(770) 834-3336

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Carrollton Surgical Group P a3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Carrollton Surgical Group, P. a.

  • Surgery Physician
  • Carrollton, GA
  • NPI 1417931825
  NPD tax ID
• Carrollton Surgical Group, P. a.

  • Surgery Physician
  • Bremen, GA
  • NPI 1578504700
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033315924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 CLINIC AVE",
            "address_2": "SUITE 302",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174454",
            "telephone_number": "770-834-3336",
            "fax_number": "770-832-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MAIN ST S",
            "city": "WEDOWEE",
            "state": "AL",
            "postal_code": "362785139",
            "telephone_number": "770-834-3336",
            "fax_number": "770-832-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLLTON SURGICAL GROUP, P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZEIS",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "770-834-3336"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RRY",
            "identifier": "CB2397",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55001589A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Syed Ahmed, MD
• Emily Aldredge, LICSW
• Kay Baker, MS
• Christy Lee Bolt, PHARM D
• Kimberly L Buckalew, CRNP
• Confluent Counseling, LLC
• Shanda Cotney, CRNP
• Richard Daniel, CRNP
• DMTT LLC (H&M Drugs)
• DMTT LLC (H&M Drugs)

• Surgery Physician in Wedowee, AL
• Providers in Wedowee, AL by specialty
• Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.