NPI | 1356429765 |
---|---|
Doing Business As | ASC OF BAUCOM & MINA DERM SURGERY |
Entity Type | Organization |
Authorized Contact | MARK BAUCOM President 404-844-0496 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2006-11-02 |
Last Update Date | 2023-12-13 |