NPI age
19 years
Enumerated 2007-03-06
● Active Type 2 · Organization
Azalea Center For Plastic Surgery Pc
Azalea Center For Plastic Surgery Pc is 1 of 1881 specialist organizations in Georgia.
Primary specialty
Specialist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Moore
Medical Director
Last NPPES update
2014-02-06
Source: monthly bulk 2026-05
How this organization compares
Across 1881 active specialist providers in Georgia.
NPI age
19 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-03Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
2810 N Oak St
Valdosta, GA 316021716
Mailing address
2810 N Oak St
Valdosta, GA 316021716
Authorized official
Bridgett Moore, MD
Medical Director
📞 2292590019
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Derrick Easom Nurse Practitioner NPI 1487138251
- Bridgett Moore, M.D. Specialist NPI 1679764757
- Candace Roman Nurse Practitioner NPI 1942085220
Specialties
-
Specialist PrimaryAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 110206439 | MEDICARE RR PROVIDER # |
| 01 (GA) | 598880 | BCBS GA PROVIDER # |
| 05 (GA) | 00830277A | |
| 01 (GA) | 511G700695 | MEDICARE GROUP PIN |
Practice context
Multi-provider organization. 3 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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