Healthcare Provider Details

I. General information

NPI: 1205607447
Provider Name (Legal Business Name): SUMMIT SURGERY CENTER OF DULUTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3775 VENTURE DR STE 100
DULUTH GA
30096-5102
US

IV. Provider business mailing address

2253 NORTHWEST PKWY SE
MARIETTA GA
30067-8764
US

V. Phone/Fax

Practice location:
  • Phone: 678-701-2225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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. DAVID HOLLIFIELD
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 678-701-2225