SOUTHERN CROSS SURGERY CENTER LLC NPI 1225321508

NPI Information

NPI: 1225321508
Provider Name: SOUTHERN CROSS SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
1301 SIGMAN RD NE
SUITE 120
CONYERS, GA
ZIP 30012
Phone: (770) 760-9360
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SOUTHERN CROSS SURGERY CENTER, LLC is an ambulatory surgical clinic center in Conyers, GA. SOUTHERN CROSS SURGERY CENTER, LLC NPI is 1225321508. The provider is registered as an organization entity type.

The provider's business location address is:

1301 SIGMAN RD NE
SUITE 120
CONYERS, GA
ZIP 30012-812
Phone: (770) 760-9360

The provider's authorized official is R. L. Talley .
The authorized official title is Md/owner and has the following contact phone number (770) 760-9360.

The enumeration date for this NPI number is 5/19/2011 and was last updated on 4/29/2015.

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
1	261Q00000X	Clinic/Center		29957	GEORGIA	No
2	261QA1903X	Clinic/Center	Ambulatory Surgical	029957	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	202G490818	OTHER	GEORGIA	MEDICARE PTAN

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

NPI Synchronization or Removal

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