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ADVANCED SURGICAL SPECIALISTS OF NORTHEAST GEORGIA LLC NPI 1346420858


NPI Information

NPI: 1346420858
Provider Name: ADVANCED SURGICAL SPECIALISTS OF NORTHEAST GEORGIA, LLC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1359 MILSTEAD RD NE
SUITE 203
CONYERS, GA
ZIP 30012
Phone: (678) 413-2182
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ADVANCED SURGICAL SPECIALISTS OF NORTHEAST GEORGIA, LLC is a specialist in Conyers, 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. ADVANCED SURGICAL SPECIALISTS OF NORTHEAST GEORGIA, LLC NPI is 1346420858. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1359 MILSTEAD RD NE
SUITE 203
CONYERS, GA
ZIP 30012-865
Phone: (678) 413-2182
Fax: (678) 413-2184

The provider's authorized official is Kermie Lenard Robinson .
The authorized official title is Owner, Sole Proprieter and has the following contact phone number (678) 413-2182.

The enumeration date for this NPI number is 11/13/2007 and was last updated on 9/5/2008.


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
1174400000XSpecialist033440GEORGIAYes

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
1000458092CMEDICAIDGEORGIA
2GRP7563MEDICARE PINGEORGIA
3E22107MEDICARE UPINGEORGIA
4DE9275OTHERGEORGIAMEDICARE RAILROAD GROUP

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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