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CARROLLTON SURGICAL GROUP P. A. NPI 1417931825


NPI Information

NPI: 1417931825
Provider Name: CARROLLTON SURGICAL GROUP, P. A.
Classification: Surgery - 208600000X
Entity Type: Organization

CLIA Number: 11D0712701

Address:
157 CLINIC AVE
SUITE 302
CARROLLTON, GA
ZIP 30117
Phone: (770) 834-3336
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CARROLLTON SURGICAL GROUP, P. A. is a surgery in Carrollton, GA. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. CARROLLTON SURGICAL GROUP, P. A. NPI is 1417931825. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

157 CLINIC AVE
SUITE 302
CARROLLTON, GA
ZIP 30117-413
Phone: (770) 834-3336
Fax: (770) 832-2136

The provider's authorized official is Jan M Zeis .
The authorized official title is Practice Administrator and has the following contact phone number (770) 834-3336.

The CLIA number assigned to this NPI record is 11D0712701 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/30/2005 and was last updated on 8/22/2020.


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
1208600000XSurgeryYes

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
155001589AMEDICAIDGEORGIA

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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