Organization
SURGICAL ASSOCIATES OF SOUTH GEORGIA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY LYNN CROFT (OFFICE MANAGER)
(229) 985-1080
Entity
Organization
Contact information
Practice address
3004 2ND ST SE, MOULTRIE, GA 31768-6797
(229) 985-1080
(229) 890-9743
Mailing address
3004 2ND ST SE, MOULTRIE, GA 31768-6797
(229) 985-1080
(229) 890-9743
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP2637
MEDICARE GROUP NUMBER
GA
Enumeration date
10/04/2007
Last updated
10/04/2007
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