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General NPI Number Information
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NPI Number | 1194977561
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Entity Type | Organization
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Legal Business Name | OAKLAND SURGICAL, LLC
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 01/31/2011
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Provider Practice Location Address
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Address Line | 257 LAWRENCE ST NE
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City | MARIETTA
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State | GA
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Zip | 30060-1647
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Country | US
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Telephone | 404-899-3800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 92
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City | MARIETTA
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State | GA
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Zip | 30061-0092
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Country | US
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Telephone | 404-899-3800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEBORAH SCHREER
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Credential | CRNFA
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Telephone | 404-899-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | RN069889
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License Number State | GA
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