NPI age
20 years
Enumerated 2005-11-03
● Active Type 2 · Organization
Southern Crescent Ent, P.c.
Southern Crescent Ent, P.c. is 1 of 450 otolaryngology organizations in Georgia.
Primary specialty
Otolaryngology
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Elliott
Practicie Manager
Last NPPES update
2011-11-14
Source: monthly bulk 2026-05
How this organization compares
Across 450 active otolaryngology providers in Georgia.
NPI age
20 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
1
In the 30% of peers with subspecialties
NPI lifetime · 2005 → 2026
2005-11Enumerated in NPPES
2005
2026
Where they practice
Primary practice location
1101 Hospital Dr, Suite 100a
Stockbridge, GA 302819075
Mailing address
1101 Hospital Dr, Suite 100a
Stockbridge, GA 302819075
Authorized official
Melissa Jean Elliott
Practicie Manager
📞 7704747416
Individual providers at this organization
6 individual providers on file at this primary practice address.
- Michael Avidano, M.D. Otolaryngology NPI 1780680462
- Blanca Durand, M.D. Otolaryngology NPI 1902802689
- Steven Leard, M.D. Pediatrics NPI 1093706426
- Christina Luczynski, AU.D. Audiologist NPI 1376565887
- Harold Moss, M.D. Otolaryngology NPI 1598761280
- Andrea Stack, AU.D. Audiologist NPI 1154331676
Specialties
-
Otolaryngology PrimaryAn otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures...
-
OtolaryngologyAn 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,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00677553A |
Practice context
Multi-provider organization. 6 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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