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General NPI Number Information
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NPI Number | 1881612042
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Entity Type | Organization
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Legal Business Name | THE HAND AND UPPER EXTREMITY SURGERY CENTER OF GEORGIA, LLC
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 993-D JOHNSON FERRY ROAD SUITE 200
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City | ATLANTA
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State | GA
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Zip | 30342
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Country | US
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Telephone | 404-969-1996
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Fax | 404-969-1999
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Provider Business Mailing Address
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Address Line | 993-D JOHNSON FERRY ROAD SUITE 200
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City | ATLANTA
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State | GA
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Zip | 30342
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Country | US
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Telephone | 404-969-1996
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Fax | 404-969-1999
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Authorized Official
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Title or Position | VICE PRESIDENT, ADMIN SERVICES/CCO
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Name | JORGE J. HERNANDEZ
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Credential |
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Telephone | 404-851-6378
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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 | 060-293
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License Number State | GA
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