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General NPI Number Information
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NPI Number | 1124653456
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Entity Type | Organization
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Legal Business Name | OASIS SURGICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 03/06/2020
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 10175 DALLAS ACWORTH HWY STE 103-14
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City | DALLAS
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State | GA
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Zip | 30132-9300
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Country | US
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Telephone | 678-481-1647
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Fax | 770-336-6620
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Provider Business Mailing Address
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Address Line | 10175 DALLAS ACWORTH HWY STE 103-14
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City | DALLAS
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State | GA
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Zip | 30132-9300
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Country | US
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Telephone | 678-758-8164
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Fax | 770-336-6620
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JACKIE LYNN SCHUMAKER
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Credential | CSFA
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Telephone | 678-758-8164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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