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PEACHTREE SURGICAL ASSISTANTS INC NPI 1184252595


NPI Information

NPI: 1184252595
Provider Name: PEACHTREE SURGICAL ASSISTANTS INC
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 11D2119716

Address:
59 ANDERSON AVE APT 127
CANTON, GA
ZIP 30114
Phone: (855) 816-7112
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PEACHTREE SURGICAL ASSISTANTS INC is a specialist in Canton, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PEACHTREE SURGICAL ASSISTANTS INC NPI is 1184252595. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

59 ANDERSON AVE APT 127
CANTON, GA
ZIP 30114-330
Phone: (855) 816-7112

The provider's authorized official is Thomas Kirk .
The authorized official title is Chief Executive Officer and has the following contact phone number (832) 804-8703.

The CLIA number assigned to this NPI record is 11D2119716 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/31/2020 and was last updated on 3/31/2020.


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
1174400000XSpecialistYes

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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