South Georgia Surgical Clinic PC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

SOUTH GEORGIA SURGICAL CLINIC PC

Doing business as

South Georgia Surgical Clinic PC

Practice address

1007 Greenfield Dr
Tifton, GA 31794-3795

Phone

(229) 382-9733

Fax

(229) 387-6161

NPI assigned

Mar 30, 2006

Last updated

Jul 21, 2022By 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. Joel M Johnson, MDNPI 1649247370

Title

President

Phone

(229) 382-9733

Specialties & licenses 1

Addresses

Other names 1

• SOUTH GEORGIA SURGICAL CLINIC PC Doing business as

Locations

Practitioners 2

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.

• Joel M Johnson, MD

  • Surgery Physician
  • Tifton, GA
  • NPI 1649247370
  Authorized official Same address or phone
• Allison Marie Bell, PA

  • Physician Assistant
  • Tifton, GA
  • NPI 1518257393
  NPD

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1770544694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 GREENFIELD DR",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943795",
            "telephone_number": "229-382-9733",
            "fax_number": "229-387-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 GREENFIELD DR",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943795",
            "telephone_number": "229-382-9733",
            "fax_number": "229-387-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GEORGIA SURGICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-382-9733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH GEORGIA SURGICAL CLINIC PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Georgia Eye Partners PC
• South Georgia Medicine, P.C.
• South Georgia Neurological Associates, P.C.
• South Georgia Pain Management
• South Georgia Physicians for Women
• South Georgia Vascular Clinic (TIft Regional Medical Center d/b/a South Georgia Vascular Clinic)
• South Georiga Homecare Inc
• South Health District (Tift County Board of Health)
• South Health District (Lowndes Co BOH AHPC - Tifton)
• Southern Elite Care LLC

• Vascular Surgery Physician in Tifton, GA
• Providers in Tifton, GA by specialty
• Vascular Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.