● Active Type 2 · Organization
South Georgia Vascular Clinic
Surgery·Tifton, GA· NPI 1144454059
·
Enumerated 2009 · 17 years on NPI
South Georgia Vascular Clinic is 1 of 268 surgery organizations in Georgia.
NPI age
17 years
Enumerated 2009-05-06
Primary specialty
Surgery
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Crum
Vp/cfo
Last NPPES update
2009-05-06
Source: monthly bulk 2026-05
How this organization compares
Across 268 active surgery providers in Georgia.
NPI age
17 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
NPI lifetime · 2009 → 2026
2009-05Enumerated in NPPES
2009
2026
Where they practice
Primary practice location
901 18th St E
Tifton, GA 317943648
📞 2293829733fax 2293876161
Mailing address
901 18th St E
Tifton, GA 317943648
📞 2293829733fax 2293876161
Authorized official
Dennis Crum
Vp/cfo
📞 2293536146
Individual providers at this organization
20 individual providers on file at this primary practice address.
-
Jose Abantao, PT
Physical Therapist
NPI 1003936246
-
Parisa Abraham, MD
Internal Medicine
NPI 1275129744
-
William Alexander, D.O.
Hospitalist
NPI 1639303589
-
Justin Allen
Emergency Medicine
NPI 1952545550
-
Ibrahim Al Marei, MD
Anesthesiology
NPI 1497366017
-
Raymond Alvarez, DO
Internal Medicine
NPI 1063090462
-
Summer Alvarez, DO
Family Medicine
NPI 1053999458
-
Francis Ampadu, D.O.
Hospitalist
NPI 1083812515
-
Alonso Arcadia-Reynoso, CRNA
Nurse Anesthetist, Certified Registered
NPI 1992698997
-
Nicholas Arnold, MD
Internal Medicine
NPI 1497383293
-
Luanne Ashton, FNP
Nurse Practitioner
NPI 1669078747
-
David Atkins, APRN-BC
Nurse Practitioner
NPI 1013926229
-
Logan Balkcom
Anesthesiologist Assistant
NPI 1891457768
-
Jessica Beier, M.D.
Pathology
NPI 1366437444
-
Corey Bichel, DO
Radiology
NPI 1649790684
-
Garrett Blalock, PA-C
Physician Assistant
NPI 1558739003
-
Kathryn Blevins, PA
Physician Assistant
NPI 1942512561
-
David Bobo, CRNA
Nurse Anesthetist, Certified Registered
NPI 1770574386
-
Penny Booth, CFNP
Nurse Practitioner
NPI 1710078423
-
Andrea Boutwell, ST
Speech-Language Pathologist
NPI 1891815049
Specialties
-
Surgery
Primary
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
GA license #031466 taxonomy 2086S0129X
Identifiers
| Type | Value | Notes |
| 01 (GA) |
1003883612 |
NPI/WILLIAM KAISER, MD |
| 01 (GA) |
1154356889 |
NPI/BRAD HOLT PA |
| 05 (GA) |
205810921C |
|
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
Practice context
Multi-provider organization.
20 individual providers on file at this primary address.
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How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.