MEDICARE: STEPHANIE UPCHURCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZC0007X	Surgical Assistant	135982	GA

General Provider Information

NPI Number	:	1558712513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE UPCHURCH

Provider Business Mailing Address
First Line	:	5670 PEACHTREE DUNWOODY RD STE 820
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-4717
Country	:	US
Telephone Number	:	404-851-1998
Fax Number	:	678-852-7946

Provider Business Practice Location Address
First Line	:	5670 PEACHTREE DUNWOODY RD STE 820
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-4717
Country	:	US
Telephone Number	:	404-851-1998
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2016
Last Update Date	:	03/24/2026

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Directions to “ STEPHANIE UPCHURCH ” Practice Location

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