NPI age
20 years
Enumerated 2005-12-06
● Active
Type 1 · Individual
Carolyn Kinzer-Bezanson Wall, M.D.
Wall is 1 of 20 pathology providers in Brunswick and 1 of 483 in Georgia.
Primary specialty
Pathology
Plus 4 subspecialties
Licensed in
GA, FL, SC, AL, LA
5 states
Status
Active
No deactivations on record
Last NPPES update
2014-12-05
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 483 active pathology providers in Georgia.
NPI age
20 years
≈ at median (19 yr)
State licenses
5 states
Top 85% — 14% of peers are multi-state
Subspecialties
0
31% of peers hold subspecialties
NPI lifetime · 2005 → 2026
2005-12Enumerated in NPPES
2005
2026
Where they practice
Practice location
203 Indigo Drive, Southeastern Pathology Associates, Pc
Brunswick, GA 31525
Mailing address
Po Box 30309
Charleston, SC 29417
Specialties
-
Pathology PrimaryA pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000931356F | |
| 05 (GA) | 000931356B | |
| 05 (GA) | 000931356A | |
| 05 (GA) | 000931356C | |
| 05 (GA) | 000931356D | |
| 05 (GA) | 000931356 | |
| 05 (GA) | 000931356E | |
| 05 (GA) | 000931356I |
Multi-state credentialing: Licensed in 5 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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