CAROLYN KINZER-BEZANSON WALL M.D. NPI 1124002712

NPI Information

  • NPI: 1124002712
  • Provider Name: CAROLYN KINZER-BEZANSON WALL, M.D.
  • Classification: Pathology - 207ZP0102X
  • Specialization: Anatomic Pathology & Clinical Pathology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 203 INDIGO DRIVE
    SOUTHEASTERN PATHOLOGY ASSOCIATES, PC
    BRUNSWICK, GA
    ZIP 31525
  • Phone: (912) 279-1900

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NPI Details

Carolyn Kinzer-bezanson Wall, M.D. is an anatomic pathology and clinical pathology pathology in Brunswick, GA with 33 years of experience. The provider is a pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. Carolyn Kinzer-bezanson Wall, M.D. NPI is 1124002712. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduation Year:1992

The provider's business location address is:

203 INDIGO DRIVE
SOUTHEASTERN PATHOLOGY ASSOCIATES, PC
BRUNSWICK, GA
ZIP 31525
Phone: (912) 279-1900
Fax: (912) 261-0753

The NPI 1124002712 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Pathology examination of tissue using a microscope, intermediate complexity (HCPCS:88305)
  • Cell examination of specimen, selective cellular enhancement technique (HCPCS:88112)
  • Pathology examination of tissue using a microscope, intermediate complexity (HCPCS:88305)
  • Cell examination of urine, computer-assisted (HCPCS:88121)
  • Evaluation of fine needle aspirate with interpretation and report (HCPCS:88173)
  • Special stained specimen slides to examine tissue, initial procedure (HCPCS:88342)
  • Cell examination of specimen, selective cellular enhancement technique (HCPCS:88112)
  • Pathology examination of tissue using a microscope, moderately low complexity (HCPCS:88304)
  • Pathology examination of tissue using a microscope, moderately low complexity (HCPCS:88304)
  • Special stained specimen slides to examine tissue, initial procedure (HCPCS:88342)
  • Pathology examination of specimen during surgery, first tissue block (HCPCS:88331)

The enumeration date for this NPI number is 12/6/2005 and was last updated on 12/5/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207ZP0102XPathologyAnatomic Pathology & Clinical Pathology038275GEORGIAYes
2207ZP0102XPathologyAnatomic Pathology & Clinical PathologyME85489FLORIDANo
3207ZP0102XPathologyAnatomic Pathology & Clinical PathologyMD29387SOUTH CAROLINANo
4207ZP0102XPathologyAnatomic Pathology & Clinical PathologyMD317652ALABAMANo
5207ZP0102XPathologyAnatomic Pathology & Clinical PathologyMD.12093R/INACTIVELOUISIANANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000931356CMEDICAIDGEORGIA
2000931356MEDICAIDGEORGIA
322BDDGKMEDICARE PINGEORGIA
4000931356AMEDICAIDGEORGIA
5000931356BMEDICAIDGEORGIA
6000931356DMEDICAIDGEORGIA
7000931356IMEDICAIDGEORGIA
8G91483MEDICARE UPINGEORGIA
9000931356FMEDICAIDGEORGIA
10000931356EMEDICAIDGEORGIA
11220032605MEDICARE PINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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