NPIMap

Organization Active NPI

Southwest Surgical Associates, P.C.

  • Surgery Physician
  • Jesup, GA
National Provider Identifier
1043577364
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
055788 Issued in GA
Legal business name
SOUTHWEST SURGICAL ASSOCIATES, P.C.
Doing business as
Southwest Surgical Associates, P.C.
Practice address
311 Peachtree St
Jesup, GA 31545-0245
Phone
(912) 427-9169
Fax
(912) 427-9171
NPI assigned
Apr 12, 2012
Last updated
Apr 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Authorized official

Name
Dr. Reginald A Williams, MDNPI 1174692891
Title
MD/Owner
Phone
(912) 427-9169

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 055788 GA Primary

Addresses

Primary practice location

311 Peachtree St
Jesup, GA 31545-0245

Mailing address

PO Box 467
Jesup, GA 31598-0467
Phone (912) 427-9169

Other names 1

  • Southwest Surgical Associates, P.C. Doing business as

National Provider Directory

National Provider Directory

Locations

113 Colonial Way
Jesup, GA 31545
Phone (912) 427-6915

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1043577364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 467",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315980467",
            "telephone_number": "912-427-9169",
            "fax_number": "912-427-9171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 PEACHTREE ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450245",
            "telephone_number": "912-427-9169",
            "fax_number": "912-427-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SURGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-12",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "912-427-9169",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "055788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Surgical Associates, P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jesup, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.