NPI Code Detail JSON Logo

1477560340 NPI number — WELLSTAR DOUGLAS SURGICAL ASSOCIATES, LLC

NPI Number: 1477560340
Health Care Provider/Practitioner: WELLSTAR DOUGLAS SURGICAL ASSOCIATES, LLC

Information about “1477560340” NPI (WELLSTAR DOUGLAS SURGICAL ASSOCIATES, LLC) exists in 1477560340 in HTML format HTML  |  1477560340 in plain Text format TXT  |  1477560340 in PDF (Portable Document Format) PDF  |  1477560340 in an XML format XML  formats.

NPI Number : 1477560340 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1477560340",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "WELLSTAR HEALTH SYSTEM, INC.",
    "ParentOrgTIN": null,
    "OrgName": "WELLSTAR DOUGLAS SURGICAL ASSOCIATES, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6002 PROFESSIONAL PARKWAY",
    "SecondLineMailingAddress": "SUITE 260",
    "MailingAddressCityName": "DOUGLASVILLE",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30134",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "770-942-4822",
    "MailingAddressFaxNumber": "770-942-5311",
    "FirstLinePracticeLocationAddress": "6002 PROFESSIONAL PARKWAY",
    "SecondLinePracticeLocationAddress": "SUITE 260",
    "PracticeLocationAddressCityName": "DOUGLASVILLE",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30134",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "770-942-4822",
    "PracticeLocationAddressFaxNumber": "770-942-5311",
    "EnumerationDate": "08/02/2006",
    "LastUpdateDate": "07/14/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ASHE",
    "AuthorizedOfficialFirstName": "NICOLE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR OF FINANCE",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "770-792-5261",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "208600000X",
        "TaxonomyName": "Surgery Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.