Southern Surgical PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SOUTHERN SURGICAL PC

Practice address

2406 Bellevue Rd
#11 Erin Office Park
Dublin, GA 31021-2842

Phone

(478) 275-2454

Fax

(478) 275-0991

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. William (Bill) H Moses Jr., M.D.

Title

Owner

Phone

(478) 275-2454

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Vein Clinic and MediSpa Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

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

• John L Polhill, MD

  • Surgery Physician
  • Dublin, GA
  • NPI 1841208279
  Medicare reassignment NPD
• William H Moses Jr., M.D.

  • Surgery Physician
  • Dublin, GA
  • NPI 1447284120
  NPD

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185926400000",
    "number": "1700905593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310400010",
            "telephone_number": "478-275-2454",
            "fax_number": "478-275-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2406 BELLEVUE RD",
            "address_2": "#11 ERIN OFFICE PARK",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212842",
            "telephone_number": "478-275-2454",
            "fax_number": "478-275-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SURGICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-08-01",
        "status": "A",
        "authorized_official_last_name": "MOSES",
        "authorized_official_first_name": "WILLIAM (BILL)",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-275-2454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTH CARE GROUP #",
            "identifier": "2524982",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Vein Clinic and MediSpa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southern Home Care Services, Inc.
• Southern Home Care Services, Inc.
• Southern Internal Medicine LLC
• Southern Radiology Services
• Southern Speech Pathology Services, LLC
• Southland Operations LLC
• Souza Family Health & Urgent Care Center, LLC
• John W Souza, MD
• Sandra L Souza, M.D.
• Robert Moses Spaulding II, PHD, LPC, MAC, CAADC

• Specialist in Dublin, GA
• Providers in Dublin, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.