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General NPI Number Information
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NPI Number | 1275597056
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Entity Type | Organization
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Legal Business Name | SURGERY CENTER OF ROME, LP
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 16 JOHN MADDOX DR NW
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City | ROME
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State | GA
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Zip | 30165-1414
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Country | US
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Telephone | 706-802-3727
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Fax | 706-802-3883
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Provider Business Mailing Address
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Address Line | 16 JOHN MADDOX DR NW
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City | ROME
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State | GA
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Zip | 30165-1414
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Country | US
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Telephone | 706-802-3727
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Fax | 706-802-3883
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Authorized Official
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Title or Position | CFO
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Name | JEFFREY PRUSIA
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Credential |
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Telephone | 706-879-4795
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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 | 057282
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License Number State | GA
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