Healthcare Provider Details

I. General information

NPI: 1639853252
Provider Name (Legal Business Name): CHIEF SURGICAL ASSISTANTS NETWORK, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/14/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEVEN HILLS BLVD STE 101-373
DALLAS GA
30132-0574
US

IV. Provider business mailing address

80 SEVEN HILLS BLVD STE 101-373
DALLAS GA
30132-0574
US

V. Phone/Fax

Practice location:
  • Phone: 770-658-6251
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY BURDETT
Title or Position: DIRECTOR
Credential: CSFA
Phone: 770-658-6251