Provider Demographics
NPI:1023005675
Name:ALBANY SURGICAL, P.C.
Entity type:Organization
Organization Name:ALBANY SURGICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-434-4200
Mailing Address - Street 1:605 N WESTOVER BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-2188
Mailing Address - Country:US
Mailing Address - Phone:229-434-4200
Mailing Address - Fax:229-434-1488
Practice Address - Street 1:605 N WESTOVER BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-2188
Practice Address - Country:US
Practice Address - Phone:229-434-4200
Practice Address - Fax:229-434-1488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA300026096AMedicaid
GA300026096CMedicaid
GA300026096AMedicaid
GA300026096CMedicaid