# SGI SURGICAL LLC

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

## Provider details

- **NPI number:** 1972822062
- **Authorized official:** STEPHANIE INGRAM (CSA)
- **Authorized official phone:** (770) 354-6940

## Contact information

- **Practice address:** 65 MOTE CROSSING RD, COVINGTON, GA 30016-5253
- **Practice address phone:** (770) 354-6940
- **Practice address fax:** (404) 671-9110
- **Mailing address:** PO BOX 516, PORTERDALE, GA 30070-0516
- **Mailing address phone:** (770) 354-6940
- **Mailing address fax:** (404) 671-9110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | 3135 | GA | Yes |

## Other

- **Enumeration date:** 05/27/2010
- **Last updated:** 05/27/2010