Healthcare Provider Details

I. General information

NPI: 1134043102
Provider Name (Legal Business Name): J.DEWAR SURGICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3894 DEERCREEK DR
POWDER SPRINGS GA
30127-2380
US

IV. Provider business mailing address

3894 DEERCREEK DR
POWDER SPRINGS GA
30127-2380
US

V. Phone/Fax

Practice location:
  • Phone: 407-456-6222
  • Fax:
Mailing address:
  • Phone: 407-456-6222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: MS. JHEANELLE ANN ELIZABETH DEWAR
Title or Position: SURGICAL ASSISTANT
Credential: CSFA
Phone: 407-456-6222