Healthcare Provider Details

I. General information

NPI: 1952213472
Provider Name (Legal Business Name): SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PEACHTREE ST NE STE 410
ATLANTA GA
30308-2204
US

IV. Provider business mailing address

600 PEACHTREE ST NE STE 410
ATLANTA GA
30308-2204
US

V. Phone/Fax

Practice location:
  • Phone: 866-841-2730
  • Fax: 866-841-2730
Mailing address:
  • Phone: 866-841-2730
  • Fax: 866-841-2730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: DR. MADISON SIEGFRIED
Title or Position: DIRECTOR
Credential: MD
Phone: 866-841-2730