Healthcare Provider Details

I. General information

NPI: 1467594820
Provider Name (Legal Business Name): CROSSPOINT SURGICAL ASSISTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2963 LEXINGTON TRACE DR SE
SMYRNA GA
30080-3784
US

IV. Provider business mailing address

2963 LEXINGTON TRACE DR SE
SMYRNA GA
30080-3784
US

V. Phone/Fax

Practice location:
  • Phone: 706-351-1612
  • Fax:
Mailing address:
  • Phone: 706-351-1612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number2894
License Number StateGA

VIII. Authorized Official

Name: MR. SHERWOOD OWENS GRIGGS SR.
Title or Position: SURGICAL ASSISTANT
Credential: CSA
Phone: 706-351-1612