# WELLLCARE SURGICAL ASSISTING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043601016
- **Authorized official:** WILLIAM DALTON (CEO)
- **Authorized official phone:** (770) 490-8645

## Contact information

- **Practice address:** 4455 LOWER ROSWELL RD, 684121, MARIETTA, GA 30068-0149
- **Practice address phone:** (770) 490-8645
- **Mailing address:** 4455 LOWER ROSWELL RD, 684121, MARIETTA, GA 30068-0149
- **Mailing address phone:** (770) 490-8645

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | — | NULL | Yes |
| 363AS0400X | Surgical Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 02/12/2015
- **Last updated:** 03/22/2017