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General NPI Number Information
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NPI Number | 1922250356
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Entity Type | Organization
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Legal Business Name | IAS SURGERY CENTER, LLC
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 5549 GLENRIDGE DR NE SUITE 100
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City | ATLANTA
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State | GA
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Zip | 30342-1327
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Country | US
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Telephone | 404-252-3672
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Fax | 404-252-3654
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Provider Business Mailing Address
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Address Line | 5549 GLENRIDGE DR NE SUITE 100
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City | ATLANTA
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State | GA
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Zip | 30342-1327
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Country | US
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Telephone | 404-252-3672
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Fax | 404-252-3654
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JOHN ARMITAGE RUSCA
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Credential | M.D.
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Telephone | 404-252-3672
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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 |
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