1255434221 NPI number — CARROLLTON ORTHOPAEDIC SURGERY CENTER

Table of content: KELLY ANNE MORGAN FNP (NPI 1043804735)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255434221 NPI number — CARROLLTON ORTHOPAEDIC SURGERY CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARROLLTON ORTHOPAEDIC SURGERY CENTER
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:
1255434221
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
150 CLINIC AVE
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
CARROLLTON
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30117-4401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-834-0873
Provider Business Mailing Address Fax Number:
770-834-6118

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
150 CLINIC AVE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
CARROLLTON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30117-4401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-834-0873
Provider Business Practice Location Address Fax Number:
770-834-6118
Provider Enumeration Date:
09/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SLAPPEY
Authorized Official First Name:
GREGORY
Authorized Official Middle Name:
S.
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
770-834-0873

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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