Healthcare Provider Details

I. General information

NPI: 1285678532
Provider Name (Legal Business Name): GEORGIA COLON & RECTALL SURGICAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 PEACHTREE DUNWOODY RD NE SUITE 206
ATLANTA GA
30342-1703
US

IV. Provider business mailing address

5555 PEACHTREE DUNWOODY RD NE SUITE 206
ATLANTA GA
30342-1703
US

V. Phone/Fax

Practice location:
  • Phone: 404-851-1336
  • Fax: 404-252-5745
Mailing address:
  • Phone: 404-851-1336
  • Fax: 404-252-5745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GUY ROBERT ORANGIO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 770-277-4277