Southern Surgical Providers, P.C.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

SOUTHERN SURGICAL PROVIDERS, P.C.

Practice address

459 Highway 119 S
Physician Center # 2
Springfield, GA 31329-3021

Phone

(912) 352-4490

Fax

(912) 352-4845

NPI assigned

Dec 23, 2013

Last updated

Jan 13, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. R. Alexander Wynn, MD

Title

President

Phone

(912) 754-0382

Specialties & licenses 2

Addresses

Tax ID family

Southern Surgical Provider2 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.

• Southern Surgical Providers, P.C.

  • Surgery Physician
  • Springfield, GA
  • NPI 1619203809
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Alexander Wynn, M.D.

  • Surgery Physician
  • Springfield, GA
  • NPI 1790748432
  NPD

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

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1619398328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 HODGSON MEMORIAL DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062532",
            "telephone_number": "912-754-0382",
            "fax_number": "912-754-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 HIGHWAY 119 S",
            "address_2": "PHYSICIAN CENTER # 2",
            "city": "SPRINGFIELD",
            "state": "GA",
            "postal_code": "313293021",
            "telephone_number": "912-352-4490",
            "fax_number": "912-352-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SURGICAL PROVIDERS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-23",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "R.",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-754-0382",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "56939",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fawn B Smith, NP-C
• Southeast Lung & Critical Care Specialists, PC (Southeast Lung Associates)
• Southern Choices LLC
• Southern Choices of the Coast
• Southern Surgical Providers, P.C.
• Springfield Chiropractic LLC
• Kelli Stewart, NP
• Joseph Patrick Tallent, ATC
• Kimberly Bowen Thompson, M.ED., CCC-SLP
• Bethany Thornton, RN

• Surgery Physician in Springfield, GA
• Providers in Springfield, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.