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NPI Code Detail

MEDICARE: RESURGENS, LLC

MEDICARE: RESURGENS, LLC
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
1207X00000XOrthopaedic Surgery PhysicianGA

General Provider Information

NPI Number : 1952438186
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESURGENS, LLC
Provider Business Mailing Address
First Line : PO BOX 21068
Second Line :
City : BELFAST
State : ME
Zip : 04915-4107
Country : US
Telephone Number : 404-847-9999
Fax Number : 404-531-8466
Provider Business Practice Location Address
First Line : 3211 IRIS DR
Second Line :
City : COVINGTON
State : GA
Zip : 30016-0907
Country : US
Telephone Number : 770-787-4042
Fax Number : 770-787-4001
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : VALERIE R SPRINGER
Credential :
Telephone Number : 404-531-8615
Provider Enumeration Date : 02/27/2007
Last Update Date : 01/31/2023

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Directions to “RESURGENS, LLC ” Practice Location

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