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General NPI Number Information
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NPI Number | 1649682014
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Entity Type | Organization
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Legal Business Name | ENTI SURGERY CENTER LLC
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Dates
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Enumeration Date | 05/20/2014
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 1595 HIGHWAY 34 E
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City | NEWNAN
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State | GA
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Zip | 30265-2353
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Country | US
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Telephone | 770-740-1860
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Fax | 678-347-2104
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Provider Business Mailing Address
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Address Line | 1595 HIGHWAY 34 E
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City | NEWNAN
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State | GA
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Zip | 30265-2353
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Country | US
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Telephone | 678-206-2494
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Fax | 678-347-2104
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Authorized Official
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Title or Position | OWNER
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Name | JOHN H LLOYD
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Credential | MD
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Telephone | 770-740-1860
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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 | 038-504
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License Number State | GA
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