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General NPI Number Information
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NPI Number | 1962531988
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Entity Type | Organization
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Legal Business Name | PIEDMONT SURGERY CENTER
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4660 RIVERSIDE PARK BLVD
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City | MACON
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State | GA
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Zip | 31210-1395
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Country | US
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Telephone | 478-471-6300
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Fax | 478-471-6240
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Provider Business Mailing Address
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Address Line | PO BOX 18065
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City | MACON
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State | GA
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Zip | 31209-8065
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Country | US
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Telephone | 478-471-6300
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Fax | 478-471-6240
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Authorized Official
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Title or Position | CEO
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Name | MIKELL PEED
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Credential |
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Telephone | 478-471-6300
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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 | 011-057
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License Number State | GA
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