Specified Solutions Surgical Associates, Inc.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

2610 Issued in DC

Legal business name

SPECIFIED SOLUTIONS SURGICAL ASSOCIATES, INC.

Practice address

156 Foster Dr Ste a
McDonough, GA 30253-5346

Phone

(404) 932-0295

NPI assigned

Sep 23, 2015

Organization subpart

No

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

Authorized official

Name

Jerrod Laquinton Williams Sr., CSA

Title

Owner

Phone

(404) 932-0295

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764892800000",
    "number": "1255700092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 ARABELLA PKWY",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302484250",
            "telephone_number": "404-932-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 FOSTER DR STE A",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302535346",
            "telephone_number": "404-932-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIFIED SOLUTIONS SURGICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JERROD",
        "authorized_official_middle_name": "LAQUINTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-932-0295",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "CSA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "DC",
            "license": "2610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in McDonough, GA
• Providers in McDonough, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; 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.