Southern Surgery Center LLC
Anesthesiology in Lagrange, GA. Organization (NPI-2).
NPI number1639326994
StatusActive
Last updated in NPPESJun 22, 2010
Details
- NPI
- 1639326994
- Entity type
- Organization (NPI-2)
- Legal business name
- Southern Surgery Center LLC
- Organization subpart
- No
- Enumeration date
- Aug 19, 2008
- Last updated
- Jun 22, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207L00000X | Anesthesiology | – | – | Yes |
Other names
- Southern Surgery Center Anesthesia Group (Other Name)
Practice location
1805 Vernon RdSuite C
Lagrange, GA 30240-3871
Phone 706-812-9902 · Fax 706-812-0802
Mailing address
1805 Vernon RdSuite C
Lagrange, GA 30240-3871
Phone 706-812-9902 · Fax 706-812-0802
Authorized official
Pat Thompson
Bom
7068129902
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