NPIMap

Organization Active NPI

Southern Surgical Associates, P. a.

  • Specialist
  • Hattiesburg, MS
National Provider Identifier
1609964600
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
15260 Issued in MS
Legal business name
SOUTHERN SURGICAL ASSOCIATES, P. A.
Practice address
39 Franklin Rd
Suite 220
Hattiesburg, MS 39402-1588
Phone
(601) 450-2401
Fax
(601) 450-2434
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. George James Azar III, M. D.NPI 1376632307
Title
President
Phone
(601) 450-2401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 15260 MS Primary

Addresses

Primary practice location

39 Franklin Rd
Suite 220
Hattiesburg, MS 39402-1588

Mailing address

39 Franklin Rd
Suite 220
Hattiesburg, MS 39402-1588
Phone (601) 450-2401

Other identifiers 1

IdentifierTypeStateIssuer
00118119MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Southern Surgical Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609964600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 FRANKLIN RD",
            "address_2": "SUITE 220",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021588",
            "telephone_number": "601-450-2401",
            "fax_number": "601-450-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 FRANKLIN RD",
            "address_2": "SUITE 220",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021588",
            "telephone_number": "601-450-2401",
            "fax_number": "601-450-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SURGICAL ASSOCIATES, P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AZAR",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-450-2401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "MS",
            "license": "15260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00118119",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.