Healthcare Provider Details
I. General information
NPI: 1568984375
Provider Name (Legal Business Name): AMERICAN ACCESS CARE OF ATLANTA ASC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/13/2017
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
250 E PONCE DELEON AVENUE SUITE 100
DECATUR GA
30030-3406
US
IV. Provider business mailing address
PO BOX 419861
BOSTON MA
02241-9861
US
V. Phone/Fax
- Phone: 404-377-9171
- Fax:
- Phone: 610-644-8900
- Fax: 484-924-0053
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GREGG
ARTHUR
MILLER
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 717-515-4048