SOUTHEASTERN SURGERY & SLEEP APNEA TREATMENT CTR. LLC NPI 1902935281

NPI Information

NPI: 1902935281
Provider Name: SOUTHEASTERN SURGERY & SLEEP APNEA TREATMENT CTR. LLC

Former Legal Business Name: DUBLIN SURGICAL ASSOCIATES AND HEART OF GEORGIA SLEEP MEDICINE

Classification: General Practice - 208D00000X
Entity Type: Organization

Address:
3333 NORTHSIDE DRIVE
SUITE B
MACON, GA
ZIP 31210
Phone: (478) 272-4544
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SOUTHEASTERN SURGERY & SLEEP APNEA TREATMENT CTR. LLC is a general practice in Macon, GA. SOUTHEASTERN SURGERY & SLEEP APNEA TREATMENT CTR. LLC NPI is 1902935281. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Dublin Surgical Associates And Heart Of Georgia Sleep Medicine.

The provider's business location address is:

3333 NORTHSIDE DRIVE
SUITE B
MACON, GA
ZIP 31210-590
Phone: (478) 272-4544
Fax: (478) 275-1306

The provider's authorized official is Dawn Drew .
The authorized official title is Chief Financial Officer and has the following contact phone number (478) 420-0456.

The CLIA number assigned to this NPI record is 11D2122689 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/5/2007 and was last updated on 8/6/2015.

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
1	174400000X	Specialist		039475	GEORGIA	No
2	208D00000X	General Practice		039475	GEORGIA	Yes

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
1	02BBGMB	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	MEDICARE NUMBER
2	000786354B	MEDICAID	GEORGIA
3	G66636	MEDICARE UPIN	GEORGIA
4	000786354P	MEDICAID	GEORGIA

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: 11/14/2023

NPI Synchronization or Removal

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