Healthcare Provider Details

I. General information

NPI: 1487793758
Provider Name (Legal Business Name): NORTH ATLANTA ORTHOPAEDIC SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10670 MEDLOCK BRIDGE RD
DULUTH GA
30097
US

IV. Provider business mailing address

10670 MEDLOCK BRIDGE RD
DULUTH GA
30097
US

V. Phone/Fax

Practice location:
  • Phone: 770-814-0323
  • Fax: 770-814-9677
Mailing address:
  • Phone: 770-814-0323
  • Fax: 770-814-9677

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: MR. FRED WOESTMANN
Title or Position: CFO
Credential:
Phone: 770-814-0323