SOUTHERN OTOLOGIC CLINIC PC (NPI# 1184651523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184651523 |
| Entity Type | Organization |
| Organization Name | SOUTHERN OTOLOGIC CLINIC PC |
| Practice Address |
818 Saint Sebastian Way Suite 204 Augusta GA 30901-2651 |
| Practice Telephone | 7067240668 |
| Practice Fax Number | 7067241124 |
| Mailing Telephone | 7067240668 |
| Mailing Fax Number | 7067241124 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2008-08-04 |
| Authorized Official Name | DR. WILLIAM HENRY MORETZ JR. (PRESIDENT) |
| Authorized Official Telephone | 7067240668 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0901X |
Otolaryngology Specialization: Otology & Neurotology |
24465 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
818 SAINT SEBASTIAN WAY SUITE 204 |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30901-2651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083612352 | Randy Wilson Cooper | Surgery | 818 Saint Sebastian Way, Suite 408, Augusta, GA 30901-2651 | 2005-07-12 |
| 1144697194 | Debora Sumner Mulling | Nurse Practitioner | 818 Saint Sebastian Way, Suite 308, Augusta, GA 30901-2651 | 2015-08-25 |
| 1427483155 | Erin Timmerman Cooper | Nurse Practitioner | 818 Saint Sebastian Way, Suite 307, Augusta, GA 30901 | 2013-09-12 |
| 1588902613 | Matthew K Howard, Md, LLC | Internal Medicine | 818 Saint Sebastian Way, Suite 311, Augusta, GA 30901-2651 | 2013-01-24 |
| 1760735401 | Toni Lynn Davis | Physician Assistant | 818 Saint Sebastian Way, Suite 311, Augusta, GA 30901-2651 | 2012-10-18 |
| 1104051754 | University Vascular Specialist, Inc. | Surgery | 818 Saint Sebastian Way, Suite 408, Augusta, GA 30901-2651 | 2009-05-27 |
| 1750515672 | Neighborhood Improvement Project Inc. | Legal Medicine | 818 Saint Sebastian Way, Suite 404a, Augusta, GA 30901-2651 | 2009-05-06 |
| 1407011802 | Santosh C Varkey | Internal Medicine | 818 Saint Sebastian Way, Suite 311, Augusta, GA 30901-2651 | 2008-07-24 |
| 1164685343 | University Sleep Associates | Specialist | 818 Saint Sebastian Way, Suite 101, Augusta, GA 30901-2651 | 2008-07-08 |
| 1235301771 | Brandi Nicole Pettis | Audiologist | 818 Saint Sebastian Way, Suite 204, Augusta, GA 30901-2651 | 2008-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477019925 | Courtney Erin Fairchild | Physician Assistant | 1101 15th Street, Pa-224, Augusta, GA 30901 | 2019-02-20 |
| 1699263921 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1022 Walton Way Spc C, Augusta, GA 30901 | 2018-04-23 |
| 1235684192 | Heather Raborn | Allergy & Immunology | 1350 Walton Way Ste 5100, Augusta, GA 30901 | 2016-08-22 |
| 1457690745 | Rehab Without Walls, Inc. | In Home Supportive Care | 820 St Sebastin Way Se, Augusta, GA 30901 | 2013-02-06 |
| 1861788051 | Christina Weidner Belcher | Physical Therapist | 1246 Pine St, Augusta, GA 30901 | 2011-06-25 |
| 1750695979 | C H Martin Company | Durable Medical Equipment & Medical Supplies | 1456 Walton Way Suite B, Augusta, GA 30901 | 2010-07-29 |
| 1366773905 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4027 Wheeler Rd, Augusta, GA 30901 | 2010-01-21 |
| 1851622484 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1715 Forest Drive, Augusta, GA 30901 | 2010-01-21 |
| 1760615280 | Absolute Family PCh | Point of Service | 2035 Old Savannah Rd., Augusta, GA 30901 | 2009-09-01 |
| 1073740643 | Ryan J Altenburg | Internal Medicine | 820 Saint Sebastian Way Ste 8a, Augusta, GA 30901 | 2009-06-22 |
| Find all providers in zip 30901 | ||||
| Taxonomy Code | 207YX0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otology & Neurotology |
| An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology and the etiology of diseases of the ear and temporal bone. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487041653 | Mohammad Seyyedi | Otolaryngology | 1120 15th Street, Augusta, GA 30912-0004 | 2015-04-24 |
| 1013942291 | William H Moretz | Otolaryngology | 818 Saint Sebastian Way, Suite 204, Augusta, GA 30901-2651 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144295551 | Johns Creek Ent PC | Otolaryngology | 4045 Johns Creek Pkwy, Suite C, Suwanee, GA 30024-1253 | 2006-02-20 |
| 1215928239 | Jennifer L. Tirino | Otolaryngology | 1360 Upper Hembree Rd, Suite 101, Roswell, GA 30076-1171 | 2005-10-31 |
| 1861493819 | Terrence Patrick Murphy | Otolaryngology | 5555 Peachtree Dunwoody Road, Suite G-51, Atlanta, GA 30342-1700 | 2005-08-02 |
| 1902802689 | Blanca Ileana Durand | Otolaryngology | 1101 Hospital Dr, Ste 100a, Stockbridge, GA 30281-9076 | 2005-06-27 |
| 1699250571 | Miriam Featherstone | Otolaryngology | 550 Peachtree St Ne Fl 9, Atlanta, GA 30308-2212 | 2018-09-26 |
| 1609090075 | Terrence P. Murphy, M.d., P.C. | Otolaryngology | 5555 Peachtree Dunwoody Road, Suite G-51, Atlanta, GA 30342-1700 | 2007-04-13 |
| 1578631255 | Ronald Leif Steenerson | Otolaryngology | 980 Johnson Ferry Rd, Suite 470, Atlanta, GA 30342 | 2006-12-01 |
| 1447225404 | Fermin V Stewart | Otolaryngology | 4045 Johns Creek Pkwy, Suite C, Suwanee, GA 30024-1253 | 2006-02-22 |
| 1841281391 | Southern Crescent Ent, P.C. | Otolaryngology | 1101 Hospital Dr, Suite 100a, Stockbridge, GA 30281-9075 | 2005-11-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.