NPI age
20 years
Enumerated 2005-12-14
● Active
Type 1 · Individual
Stanley A Agbulos, PA-C, AA-C
Agbulos is 1 of 17 physician assistant providers in Waycross and 1 of 4616 in Georgia.
Primary specialty
Physician Assistant
Plus 2 subspecialties
Licensed in
GA, CA
2 states
Status
Active
No deactivations on record
Last NPPES update
2011-02-28
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 4616 active physician assistant providers in Georgia.
NPI age
20 years
↑ 12 yr above median (8 yr)
State licenses
2 states
Top 90% — 9% of peers are multi-state
Subspecialties
1
In the 24% of peers with subspecialties
NPI lifetime · 2005 → 2026
2005-12Enumerated in NPPES
2005
2026
Where they practice
Practice location
410 Darling Ave
Waycross, GA 315015246
Mailing address
Po Box 18824
Greensboro, NC 274198824
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
-
Anesthesiologist AssistantAn individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 259983019A | |
| 01 (GA) | P00410142 | RRB |
| 05 (CA) | PA16336 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 27 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.