Healthcare Provider Details

I. General information

NPI: 1255434221
Provider Name (Legal Business Name): CARROLLTON ORTHOPAEDIC SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 CLINIC AVE SUITE 101
CARROLLTON GA
30117-4401
US

IV. Provider business mailing address

150 CLINIC AVE SUITE 101
CARROLLTON GA
30117-4401
US

V. Phone/Fax

Practice location:
  • Phone: 770-834-0873
  • Fax: 770-834-6118
Mailing address:
  • Phone: 770-834-0873
  • Fax: 770-834-6118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY S. SLAPPEY
Title or Position: PARTNER
Credential: M.D.
Phone: 770-834-0873