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General NPI Number Information
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NPI Number | 1558507525
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Entity Type | Organization
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Legal Business Name | PREFERRED SURGEON'S ASSISTANTS
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Dates
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Enumeration Date | 12/23/2008
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Last Update Date | 10/16/2015
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Provider Practice Location Address
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Address Line | 2483 HERITAGE VLG SUITE 16 238
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City | SNELLVILLE
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State | GA
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Zip | 30078-6140
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Country | US
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Telephone | 770-979-5207
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Fax | 770-979-5027
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Provider Business Mailing Address
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Address Line | 2483 HERITAGE VLG SUITE 16 238
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City | SNELLVILLE
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State | GA
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Zip | 30078-6140
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Country | US
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Telephone | 770-979-5207
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Fax | 770-979-5027
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Authorized Official
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Title or Position | CSA
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Name | JOHNATHAN L. HUSKEY
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Credential |
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Telephone | 404-309-4329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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