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General NPI Number Information
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NPI Number | 1639282932
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Entity Type | Organization
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Legal Business Name | ATLANTA ENDOSCOPY CENTER
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2665 N DECATUR RD SUITE 545
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City | DECATUR
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State | GA
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Zip | 30033-6149
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Country | US
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Telephone | 404-296-1986
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Fax | 404-296-9890
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Provider Business Mailing Address
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Address Line | 2665 N DECATUR RD SUITE 545
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City | DECATUR
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State | GA
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Zip | 30033-6149
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Country | US
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Telephone | 404-296-1986
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Fax | 404-296-9890
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID BENJAMIN RAUSHER
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Credential | M.D.
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Telephone | 404-296-1986
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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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