NPI Portal NPI Lookup & Verification

Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Carolyn Kinzer-Bezanson Wall, M.D.

Anatomic Pathology & Clinical Pathology Physician in Brunswick, GA · enumerated 2005.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1124002712

Verified

See something wrong? Report a correction

Registry record

Entity type Individual (Type 1)
Name Carolyn Kinzer-Bezanson Wall
Credential M.D.
Sex Female
Practice address 203 Indigo Drive, Southeastern Pathology Associates, PC, Brunswick, GA, 31525
Phone (912) 279-1900
Fax (912) 261-0753
Enumeration date Dec 6, 2005
Last updated in NPPES Dec 5, 2014

Taxonomy & licenses

207ZP0102X Anatomic Pathology & Clinical Pathology Physician Allopathic & Osteopathic Physicians · License 038275 (GA) Primary
207ZP0102X Anatomic Pathology & Clinical Pathology Physician Allopathic & Osteopathic Physicians · License ME85489 (FL) Secondary
207ZP0102X Anatomic Pathology & Clinical Pathology Physician Allopathic & Osteopathic Physicians · License MD29387 (SC) Secondary
207ZP0102X Anatomic Pathology & Clinical Pathology Physician Allopathic & Osteopathic Physicians · License MD317652 (AL) Secondary
207ZP0102X Anatomic Pathology & Clinical Pathology Physician Allopathic & Osteopathic Physicians · License MD.12093R/INACTIVE (LA) Secondary
MD · Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential

Other identifiers

Identifier Type State Issuer
000931356F Medicaid GA -
000931356B Medicaid GA -
000931356A Medicaid GA -
000931356C Medicaid GA -
000931356D Medicaid GA -
000931356 Medicaid GA -
000931356E Medicaid GA -
000931356I Medicaid GA -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

How do I verify Carolyn Wall's NPI record?
Cross-check NPI 1124002712 against the official CMS registry at npiregistry.cms.hhs.gov. This page mirrors the same public NPPES data with a monthly snapshot.
Is NPI 1124002712 active?
Yes, as of the latest NPPES snapshot, NPI 1124002712 is active (record last updated 2014-12-05).

Other providers at this practice address

Browse all →

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-12-05.