Healthcare Provider Details

I. General information

NPI: 1902823024
Provider Name (Legal Business Name): METRO SURGICAL, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 02/04/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

594 S COLUMBIA AVE SUITE 100
RINCON GA
31326-9092
US

IV. Provider business mailing address

PO BOX 919
RINCON GA
31326-0919
US

V. Phone/Fax

Practice location:
  • Phone: 912-826-4057
  • Fax: 912-826-2853
Mailing address:
  • Phone: 912-826-4057
  • Fax: 912-826-2853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SUE PAYNE
Title or Position: OFFICE MANAGER
Credential:
Phone: 912-826-4057