# GEORGIA SURGICARE

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

## Provider details

- **NPI number:** 1508150509
- **Authorized official:** CHRISTOPHER IBIKUNLE MD (CEO)
- **Authorized official phone:** (678) 466-6760

## Contact information

- **Practice address:** 367 ATHENS HWY, BUILDING 100 SUITE 100A, LOGANVILLE, GA 30052-2204
- **Practice address phone:** (678) 466-6760
- **Practice address fax:** (678) 802-7094
- **Mailing address:** 367 ATHENS HWY, BUILDING 100 SUITE 100A, LOGANVILLE, GA 30052-2204
- **Mailing address phone:** (678) 466-6760
- **Mailing address fax:** (678) 802-7094

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/07/2011
- **Last updated:** 03/20/2015