Northeast Georgia Surgical Associates PC
Specialist in Gainesville, GA. Organization (NPI-2).
NPI number1497861900
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1497861900
- Entity type
- Organization (NPI-2)
- Legal business name
- Northeast Georgia Surgical Associates PC
- Organization subpart
- No
- Enumeration date
- Aug 21, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
1075 Jesse Jewell Pkwy Ne Ste BGainesville, GA 30501-3814
Phone 770-536-5733 · Fax 770-532-8007
Mailing address
1075 Jesse Jewell Pkwy Ne Ste BGainesville, GA 30501-3814
Phone 770-536-5733 · Fax 770-532-8007
Authorized official
Gail Detraz
Administrator
7705365733
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