1144560418 NPI number — ATLANTA GENERAL SURGERY ASSOCIATES,PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144560418 NPI number — ATLANTA GENERAL SURGERY ASSOCIATES,PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATLANTA GENERAL SURGERY ASSOCIATES,PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144560418
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5755 N POINT PKWY
Provider Second Line Business Mailing Address:
SUITE 98
Provider Business Mailing Address City Name:
ALPHARETTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30022-1142
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-257-0644
Provider Business Mailing Address Fax Number:
404-257-0681

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5755 N POINT PKWY
Provider Second Line Business Practice Location Address:
SUITE 98
Provider Business Practice Location Address City Name:
ALPHARETTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30022-1142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-257-0644
Provider Business Practice Location Address Fax Number:
404-257-0681
Provider Enumeration Date:
02/25/2013

Additional Information

Authorized Official

Authorized Official Last Name:
CASE
Authorized Official First Name:
ORRETH
Authorized Official Middle Name:
BRUCE
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
404-257-0644

Provider Taxonomy Codes

  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com