Provider Demographics
NPI:1447284781
Name:SURGICAL ASSOCIATES OF ALBANY PC
Entity type:Organization
Organization Name:SURGICAL ASSOCIATES OF ALBANY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:COOPER
Authorized Official - Last Name:KEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-883-6311
Mailing Address - Street 1:425 W 3RD AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1941
Mailing Address - Country:US
Mailing Address - Phone:229-883-6311
Mailing Address - Fax:229-883-6315
Practice Address - Street 1:425 W 3RD AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1941
Practice Address - Country:US
Practice Address - Phone:229-883-6311
Practice Address - Fax:229-883-6315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========OtherTAX ID NUMBER
GAGRP3063Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER