Healthcare Provider Details

I. General information

NPI: 1730867391
Provider Name (Legal Business Name): ATLANTIC SURGICAL PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 POINTE SOUTH DR
SAVANNAH GA
31410
US

IV. Provider business mailing address

6175 HICKORY FLAT HIGHWAYS SUITE 100--406
CANTON GA
30115
US

V. Phone/Fax

Practice location:
  • Phone: 678-956-1272
  • Fax:
Mailing address:
  • Phone: 404-710-3474
  • Fax: 844-427-2845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: BETH TRIPPANY
Title or Position: MANAGER
Credential:
Phone: 844-346-8686