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General NPI Number Information
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NPI Number | 1437527363
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Entity Type | Organization
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Legal Business Name | SURGEON'S CHOICE SURGICAL ASSISTING LLC
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 10/05/2015
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Provider Practice Location Address
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Address Line | 2300 BETHELVIEW RD STE 110 #197
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City | CUMMING
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State | GA
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Zip | 30040-9475
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Country | US
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Telephone | 770-265-1432
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Fax | 678-771-8220
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Provider Business Mailing Address
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Address Line | 2300 BETHELVIEW RD STE 110 #197
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City | CUMMING
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State | GA
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Zip | 30040-9475
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Country | US
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Telephone | 770-265-1432
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Fax | 678-771-8220
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Authorized Official
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Title or Position | OWNER
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Name | ANTONIO FLENEURY
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Credential | CEO
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Telephone | 770-265-1432
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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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