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General NPI Number Information
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NPI Number | 1831557842
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Entity Type | Organization
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Legal Business Name | GOLDEN SURGICAL ASSOCIATES GROUP, LLC
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Dates
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Enumeration Date | 02/04/2016
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Last Update Date | 06/22/2018
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Provider Practice Location Address
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Address Line | 2400 OLD MILTON PARKWAY #1433
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City | ALPHARETTA
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State | GA
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Zip | 30009
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Country | US
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Telephone | 470-239-8860
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Fax | 866-830-3721
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Provider Business Mailing Address
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Address Line | PO BOX 1433
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City | ALPHARETTA
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State | GA
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Zip | 30009-1433
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Country | US
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Telephone | 470-239-8860
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Fax | 866-830-3721
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Authorized Official
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Title or Position | ED
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Name | NIKKI WILLIAMS
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Credential |
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Telephone | 404-931-0224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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