SOUTHERN OTOLOGIC CLINIC PC NPI 1184651523

NPI Information

  • NPI: 1184651523
  • Provider Name: SOUTHERN OTOLOGIC CLINIC PC
  • Classification: Otolaryngology - 207YX0901X
  • Specialization: Otology & Neurotology
  • Entity Type: Organization
  • Address: 818 SAINT SEBASTIAN WAY
    SUITE 204
    AUGUSTA, GA
    ZIP 30901
  • Phone: (706) 724-0668

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NPI Details

SOUTHERN OTOLOGIC CLINIC PC is an otology and neurotology otolaryngology in Augusta, GA. The provider is an otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology and the etiology of diseases of the ear and temporal bone. SOUTHERN OTOLOGIC CLINIC PC NPI is 1184651523. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

818 SAINT SEBASTIAN WAY
SUITE 204
AUGUSTA, GA
ZIP 30901-651
Phone: (706) 724-0668
Fax: (706) 724-1124

The provider's authorized official is William Henry Moretz .
The authorized official title is President and has the following contact phone number (706) 724-0668.

The enumeration date for this NPI number is 6/28/2006 and was last updated on 8/4/2008.

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
1207YX0901XOtolaryngologyOtology & Neurotology24465GEORGIAYes

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
1B04449MEDICARE UPINGEORGIA

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: 11/21/2025

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