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General NPI Number Information
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NPI Number | 1831301050
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Entity Type | Organization
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Legal Business Name | THE WOMEN'S SURGERY CENTER, LLC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1523 FAIR RD
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City | STATESBORO
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State | GA
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Zip | 30458-6025
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Country | US
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Telephone | 912-871-3000
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Fax | 912-871-3100
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Provider Business Mailing Address
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Address Line | PO BOX 1958
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City | STATESBORO
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State | GA
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Zip | 30459-1958
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Country | US
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Telephone | 912-871-3000
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Fax | 912-871-3100
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARY E COLLINS
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Credential |
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Telephone | 912-871-3000
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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 | 016-232
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License Number State | GA
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