Advantage Surgical and Wound Care Alabama PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

ADVANTAGE SURGICAL AND WOUND CARE ALABAMA PC

Practice address

65 Charlton PL
Deatsville, AL 36022-2697

Phone

(877) 878-3289

Fax

(877) 817-3227

NPI assigned

Oct 7, 2021

Organization subpart

No

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

Authorized official

Name

Uri Gedalia, MD

Title

President

Phone

(877) 878-3289

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1245992155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 N PACIFIC COAST HWY STE 2175",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455639",
            "telephone_number": "877-878-3289",
            "fax_number": "877-817-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 CHARLTON PL",
            "city": "DEATSVILLE",
            "state": "AL",
            "postal_code": "360222697",
            "telephone_number": "877-878-3289",
            "fax_number": "877-817-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE SURGICAL AND WOUND CARE ALABAMA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "GEDALIA",
        "authorized_official_first_name": "URI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "877-878-3289",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marijean Dale Ballard, ATC
• Christopher Luke Barkley, CRNP
• Begin Within Support Services, LLC
• Melissa Diana Bishop
• Christina Elizabeth Brady, NURSE PRACTITIONER

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.