Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenneth Moss, CSA

Individual provider Surgical Technologist · NPI 1205950680

Kenneth Moss, CSA is a Surgical Technologist in Loganville, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2007

Practice location Address checks out

2602 Fall Creek Ldg
Loganville, GA 30052-5877
Phone: (404) 310-2321
Fax: (404) 985-1694
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Technologist (primary) Taxonomy 246ZS0410X · Licence 1558 (GA)

Record details

NPI number1205950680
Entity typeIndividual (Type 1)
GenderMale
Credentials CSA
Sole proprietorYes
NPI enumeratedMarch 19, 2007
Last updated in NPPESJuly 8, 2007
Mailing addressPo Box 888235, Atlanta, GA 30356-0235