1. Home
  2. Directory
  3. Georgia
  4. Valdosta
  5. Clinic Center
  6. NPI Profile

ENT OF SOUTH GEORGIA SURGERY CENTER LLC
NPI 1104272780
Clinic/Center - Ambulatory Surgical in Valdosta, GA

Active since May 12, 2016
2805 N OAK ST, VALDOSTA, GA 31602(229) 244-2562(229) 249-0000 Get Directions Write a Review

NPPES record last updated: May 3, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ent Of South Georgia Surgery Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ENT OF SOUTH GEORGIA SURGERY CENTER LLC (NPI 1104272780) is a healthcare organization registered as an ambulatory surgical in Valdosta, Georgia and active in the NPI registry since May 2016. The organization lists Ronald V Allen, President, as its authorized official.

NPPES Registry Identity

NPI1104272780
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameENT OF SOUTH GEORGIA SURGERY CENTER LLC
Location Address2805 N OAK STValdosta, GA 31602-5922
Mailing Address2805 N Oak StValdosta, GA 31602-5922 · (229) 244-2562 · Fax (229) 249-0000
Phone(229) 244-2562
Fax(229) 249-0000
Organization SubpartYesParent: Ear, Nose, Throat And Allergy Associates Of South Georgia Pc
Authorized OfficialRonald V AllenPresident · (229) 244-2562
Enumeration DateMay 12, 2016
Last NPPES UpdateMay 3, 2017
✔ NPI 1104272780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
2805 N OAK ST, Valdosta, GA 31602
Open in Google Maps ↗

Other Identifiers 6

Medicare UPING06743GA
Medicaid000834589AGA
Medicaid000655146AGA
Medicare UPINH56636GA
Medicaid000946668AGA
Medicare UPING98411GA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2117033

Ent Of South Georgia Surgery Center, LLC · Valdosta, GA
Expired · Aug 7, 2026
CLIA Number11D2117033
Laboratory TypeAmbulance
Certificate Effective DateAugust 8, 2024
Certificate Expiration DateAugust 7, 2026
Laboratory DirectorRonald V. Allen
Laboratory Phone(229) 244-2562
Laboratory LocationEnt Of South Georgia Surgery Center, LLC2805 North Oak Street, Valdosta, GA 31602
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOUTHERN UROLOGICAL ASSOCIATES
Specialist
2805 N OAK ST, SUITE B
VALDOSTA, GA 31602
Lowndes County (229) 316-2990

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ent Of South Georgia Surgery Center LLC's NPI number?

The NPI number for Ent Of South Georgia Surgery Center LLC is 1104272780. It was assigned to this organization in the NPPES registry on May 12, 2016.

Where is Ent Of South Georgia Surgery Center LLC located?

Ent Of South Georgia Surgery Center LLC is located at 2805 N Oak St, Valdosta, GA 31602. The listed phone number is (229) 244-2562.

What is Ent Of South Georgia Surgery Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

When was this NPI record last updated?

The NPPES record for Ent Of South Georgia Surgery Center LLC was last updated on May 3, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.