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General NPI Number Information
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NPI Number | 1275542011
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Entity Type | Organization
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Legal Business Name | NORTH CRESCENT SURGERY CENTER, L.L.C.
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 08/09/2013
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Provider Practice Location Address
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Address Line | 11975 MORRIS RD SUITE 160
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City | ALPHARETTA
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State | GA
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Zip | 30005-4419
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Country | US
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Telephone | 770-360-9916
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Fax | 770-360-9937
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Provider Business Mailing Address
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Address Line | 5780 PEACHTREE DUNWOODY ROAD SUITE 300
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City | ATLANTA
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State | GA
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Zip | 30342-1513
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Country | US
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Telephone | 404-303-1224
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Fax | 404-303-1325
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Authorized Official
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Title or Position | CEO
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Name | DR. RICHARD C ZANE
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Credential | M.D.
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Telephone | 404-303-1224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 060-297
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License Number State | GA
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