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ASC OF BAUCOM & MINA DERM SURGERY JOHNS CREEK LLC NPI 1013601517


NPI Information

NPI: 1013601517
Provider Name: ASC OF BAUCOM & MINA DERM SURGERY JOHNS CREEK LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
10750 MEDLOCK BRIDGE RD STE 102
JOHNS CREEK, GA
ZIP 30097
Phone: (470) 545-2124
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ASC OF BAUCOM & MINA DERM SURGERY JOHNS CREEK LLC is an ambulatory surgical clinic center in Johns Creek, GA. ASC OF BAUCOM & MINA DERM SURGERY JOHNS CREEK LLC NPI is 1013601517. The provider is registered as an organization entity type.

The provider's business location address is:

10750 MEDLOCK BRIDGE RD STE 102
JOHNS CREEK, GA
ZIP 30097-705
Phone: (470) 545-2124
Fax: (404) 844-0499

The provider's authorized official is Mark F Baucom .
The authorized official title is Owner and has the following contact phone number (404) 844-0496.

The enumeration date for this NPI number is 6/7/2023 and was last updated on 12/13/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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