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AZALEA CENTER FOR PLASTIC SURGERY PC
NPI 1952431223
Specialist in Valdosta, GA

Active since March 06, 2007
2810 N OAK ST, VALDOSTA, GA 31602(229) 259-0019(229) 259-0209 Get Directions Write a Review

NPPES record last updated: February 6, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Azalea Center For Plastic Surgery Pc NPPES

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

AZALEA CENTER FOR PLASTIC SURGERY PC (NPI 1952431223) is a healthcare organization registered as a specialist in Valdosta, Georgia and active in the NPI registry since March 2007. The organization lists Bridgett Moore, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1952431223
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameAZALEA CENTER FOR PLASTIC SURGERY PC
Location Address2810 N OAK STValdosta, GA 31602-1716
Mailing Address2810 N Oak StValdosta, GA 31602-1716 · (229) 259-0019 · Fax (229) 259-0209
Phone(229) 259-0019
Fax(229) 259-0209
Organization SubpartNo
Authorized OfficialBridgett MooreMedical Director · (229) 259-0019
Enumeration DateMarch 6, 2007
Last NPPES UpdateFebruary 6, 2014
✔ NPI 1952431223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in GA · 39418
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
2810 N OAK ST, Valdosta, GA 31602
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Other Identifiers 6

Other110206439GA · Medicare Rr Provider #
Other598880GA · Bcbs Ga Provider #
Medicare UPINH01627GA
Medicaid00830277AGA
Other511G700695GA · Medicare Group Pin
Medicare PIN24BCBRCGA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

MRS. DERRICK LEIGH EASOM
Nurse Practitioner
2810 N OAK ST
VALDOSTA, GA 31602
Lowndes County (229) 938-6495
BRIDGETT MOORE M.D.
Specialist
2810 N OAK ST
VALDOSTA, GA 31602
Lowndes County (229) 259-0019
CANDACE ISABEL ROMAN
Nurse Practitioner
2810 N OAK ST
VALDOSTA, GA 31602
Lowndes County (229) 259-0019

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 Azalea Center For Plastic Surgery PC's NPI number?

The NPI number for Azalea Center For Plastic Surgery PC is 1952431223. It was assigned to this organization in the NPPES registry on March 6, 2007.

Where is Azalea Center For Plastic Surgery PC located?

Azalea Center For Plastic Surgery PC is located at 2810 N Oak St, Valdosta, GA 31602. The listed phone number is (229) 259-0019.

What is Azalea Center For Plastic Surgery PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Azalea Center For Plastic Surgery PC was last updated on February 6, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.