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General NPI Number Information
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NPI Number | 1588604391
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Entity Type | Organization
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Legal Business Name | HAMILTON AMBULATORY SURGERY CENTER
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1250 BROADRICK DR
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City | DALTON
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State | GA
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Zip | 30720-2503
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Country | US
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Telephone | 706-876-5000
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Fax | 706-876-5014
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Provider Business Mailing Address
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Address Line | 1250 BROADRICK DR
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City | DALTON
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State | GA
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Zip | 30720-2503
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Country | US
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Telephone | 706-876-5000
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Fax | 706-876-5014
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT
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Name | MR. GARY HOWARD
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Credential |
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Telephone | 706-226-3003
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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 | 155-242
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License Number State | GA
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