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General NPI Number Information
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NPI Number | 1467833160
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Entity Type | Organization
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Legal Business Name | AUSTELL SURGERY CENTER, LLC
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Dates
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Enumeration Date | 06/18/2015
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 1610 MULKEY RD
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City | AUSTELL
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State | GA
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Zip | 30106-1186
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Country | US
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Telephone | 770-544-0444
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Fax | 678-239-0994
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Provider Business Mailing Address
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Address Line | 1610 MULKEY RD
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City | AUSTELL
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State | GA
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Zip | 30106-1186
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Country | US
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Telephone | 678-426-2188
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Fax | 770-874-8950
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Authorized Official
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Title or Position | CEO
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Name | DAVID N HELFMAN
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Credential | DPM
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Telephone | 678-426-2171
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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 |
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License Number State | GA
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