# URGENT CARE BANKS CROSSING LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Commerce Surgical Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386802155
- **Authorized official:** MRS. LISA A BROOKSHIRE (OFFICE MANAGER)
- **Authorized official phone:** (706) 336-0074

## Contact information

- **Practice address:** 415 B POTTERY FACTORY DRIVE, COMMERCE, GA 30529
- **Practice address phone:** (706) 336-0074
- **Practice address fax:** (706) 336-0079
- **Mailing address:** P.O. BOX 1055, COMMERCE, GA 30529
- **Mailing address phone:** (706) 336-0074
- **Mailing address fax:** (706) 336-0079

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 049138 | GA | — |
| 208600000X | Surgery Physician | 049138 | GA | — |
| 208D00000X | General Practice Physician | — | GA | Yes |
| 208VP0000X | Pain Medicine Physician | 049138 | GA | — |

## Other

- **Enumeration date:** 05/29/2008
- **Last updated:** 12/28/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000771999H | — | GA |
| 01 | — | 1033127899 | NPI | GA |
| 01 | — | 1497763254 | NPI | GA |
| 05 | — | 971545216B | — | GA |