Healthcare Provider Details

I. General information

NPI: 1386793180
Provider Name (Legal Business Name): MIDTOWN SURGICAL ASSOCIATES,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 WYNGATE RD
AUBURN GA
30011-2930
US

IV. Provider business mailing address

308 WYNGATE RD
AUBURN GA
30011-2930
US

V. Phone/Fax

Practice location:
  • Phone: 404-210-1033
  • Fax: 770-963-4890
Mailing address:
  • Phone: 404-210-1033
  • Fax: 770-963-4890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT G MERCER
Title or Position: SURGICAL ASST.
Credential: CFA
Phone: 404-210-1033