NPI age
2 years
Enumerated 2024-05-15
● Active
Type 1 · Individual
Wasana J Phouangmalay, CST, CSFA
Phouangmalay is 1 of 1 specialist/technologist, other providers in Jonesboro and 1 of 399 in Georgia.
Primary specialty
Specialist/Technologist, Other
Licensed in
—
0 states
Status
Active
No deactivations on record
Last NPPES update
2024-05-15
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 399 active specialist/technologist, other providers in Georgia.
NPI age
2 years
↓ 4 yr below median (6 yr)
State licenses
1 state
2% of peers hold multiple states
Subspecialties
0
13% of peers hold subspecialties
NPI lifetime · 2024 → 2026
2024-05Enumerated in NPPES
2024
2026
Where they practice
Practice location
137 South Ave
Jonesboro, GA 302364948
Mailing address
137 South Ave
Jonesboro, GA 302364948
Specialties
-
Specialist/Technologist, Other PrimaryA surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting,...
Practice context
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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