Organization Active NPI

South Georgia Neurological Associates, P.C.

  • Clinical Neurophysiology Physician
  • Tifton, GA
National Provider Identifier
1407910607
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
GA042576 Issued in GA
Legal business name
SOUTH GEORGIA NEUROLOGICAL ASSOCIATES, P.C.
Practice address
907 18TH St E Ste 190
Tifton, GA 31794-3600
Phone
(229) 391-3390
Fax
(229) 391-3399
NPI assigned
Dec 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Authorized official

Name
Dr. Anthony George Giatras, M.D.
Title
Owner
Phone
(229) 391-3390

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084N0402X GA042576 GA
Clinical Neurophysiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084N0600X GA042576 GA Primary

Addresses

Primary practice location

907 18TH St E Ste 190
Tifton, GA 31794-3600

Mailing address

907 18TH St E Ste 190
Tifton, GA 31794-3600
Phone (229) 391-3390

National Provider Directory

National Provider Directory

Locations

1309 Ocilla Rd
Ste 1
Douglas, GA 31533
Phone (912) 383-6581

907 18th St E
Ste 190
Tifton, GA 31794
Phone (229) 391-3390

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1407910607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 18TH ST E STE 190",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943600",
            "telephone_number": "229-391-3390",
            "fax_number": "229-391-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 18TH ST E STE 190",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943600",
            "telephone_number": "229-391-3390",
            "fax_number": "229-391-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GEORGIA NEUROLOGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "GIATRAS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-391-3390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "GA",
            "license": "GA042576",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "GA",
            "license": "GA042576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.