# SOUTHERN HEALTH CORP OF ELLIJAY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** North Georgia Orthopedic Surgery and Sports Medicine Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619284445
- **Authorized official:** MS. DEBRA ANN SELF (CFO)
- **Authorized official phone:** (706) 276-4741

## Contact information

- **Practice address:** 772 MADDOX DR, SUITE 112, EAST ELLIJAY, GA 30540-8194
- **Practice address phone:** (706) 276-4399
- **Practice address fax:** (706) 276-4741
- **Mailing address:** PO BOX 1019, ELLIJAY, GA 30540-0013
- **Mailing address phone:** (706) 276-4399
- **Mailing address fax:** (706) 276-4741

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 053942 | GA | Yes |

## Other

- **Enumeration date:** 08/31/2010
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1821059510 | BRIAN ROWAN'S NPI NUMBER | GA |
| 01 | — | HOSP34 | SOUTHERN HEALTH CORP OF ELLIJAYDBA NORTH GEORGIA MEDICAL CENTER PROVIDER NUMBER | GA |