Vidalia Oral and Maxillofacial Surgery, P.C.

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

01415 Issued in GA

Legal business name

VIDALIA ORAL AND MAXILLOFACIAL SURGERY, P.C.

Practice address

310 Maple Dr
Vidalia, GA 30474-8909

Phone

(912) 537-4119

Fax

(912) 537-9117

NPI assigned

Mar 11, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Ronald O Mosley, D.M.D.

Title

President

Phone

(912) 537-4119

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1063682680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 MAPLE DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748909",
            "telephone_number": "912-537-4119",
            "fax_number": "912-537-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MAPLE DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748909",
            "telephone_number": "912-537-4119",
            "fax_number": "912-537-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDALIA ORAL AND MAXILLOFACIAL SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "MOSLEY",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-537-4119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "01415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vidalia Medical Associates, PC
• Vidalia Medical Partners Inc. (1st Choice Family Medical Group)
• Vidalia Neurology Associates, LLC
• Vidalia OB GYN
• Vidalia Open MRI, LLC
• Vidalia Orthopedic Center, LLC
• Vidalia Pharmacy Inc
• Vidalia Pulmonology Center, LLC
• Vidalia Radiology Associates
• Vidalia Regional Cancer Center

• Oral and Maxillofacial Surgery Clinic/Center in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.