Organization
SOUTHEASTERN UROLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
W WINSTON WILFONG MD (PRESIDENT)
(478) 742-5331
Entity
Organization
Contact information
Practice address
380 HOSPITAL DR, STE 320, MACON, GA 31217-8001
(478) 742-5331
(478) 750-1387
Mailing address
380 HOSPITAL DR, STE 320, MACON, GA 31217-8001
(478) 742-5331
(478) 750-1387
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
340005163
RR MEDICARE-WILFONG
GA
01
—
340007314
RR MEDICARE PATTERSON
GA
01
—
CL8455
RR MEDICARE GRP #
GA
Enumeration date
02/26/2007
Last updated
06/04/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up