| NPI | 1578536686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY L JONES Practice Administration 678-741-2317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 048324) |
| Additional Taxonomies | 261QE0800X Clinic/Center, Endoscopy |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2025-12-03 |