# SPECTRUM SURGICAL LLC

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

## Provider details

- **NPI number:** 1639704307
- **Authorized official:** FRANK PAUL TANNER CSFA, SA-C (CERTIFIED SURGICAL ASSISTANT)
- **Authorized official phone:** (678) 516-2119

## Contact information

- **Practice address:** 3142 HIGHWAY 278 NW \# 135, COVINGTON, GA 30014-2304
- **Practice address phone:** (678) 516-2119
- **Mailing address:** 3142 HIGHWAY 278 NW \# 135, COVINGTON, GA 30014-2304
- **Mailing address phone:** (678) 516-2119

## Taxonomy

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

## Other

- **Enumeration date:** 03/03/2020
- **Last updated:** 03/03/2020