Wall, Carolyn Kinzer-Bezanson
Wall, Carolyn Kinzer-Bezanson is an individual health care provider with primary practice located at 203 Indigo Drive Southeastern Pathology Associates, Pc, Brunswick GA 31525. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Wall, Carolyn Kinzer-Bezanson can be contacted via phone (912) 279-1900.Contact Information
Primary practice address
203 Indigo Drive Southeastern Pathology Associates, Pc
Brunswick GA 31525
Phone: (912) 279-1900
Fax: (912) 261-0753
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 038275 | Georgia |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | ME85489 | Florida |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | MD29387 | South Carolina |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | MD317652 | Alabama |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | MD.12093R/INACTIVE | Louisiana |
Profile Details
| NPI number | 1124002712 |
|---|---|
| LBN Legal business name | Wall, Carolyn Kinzer-Bezanson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 6th, 2005 |
| Last updated | Dec 5th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124002712 | NPPES |
| Georgia | MEDICAID | 000931356F | |
| Georgia | MEDICAID | 000931356B | |
| Georgia | MEDICAID | 000931356A | |
| Georgia | MEDICAID | 000931356C | |
| Georgia | MEDICAID | 000931356D | |
| Georgia | MEDICAID | 000931356 | |
| Georgia | MEDICAID | 000931356E | |
| Georgia | MEDICAID | 000931356I |
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