Organization
CHESTATEE SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER MCLEAN ROSS (OFFICE MANAGER)
(706) 864-7272
Entity
Organization
Contact information
Practice address
160 PROSPECTOR RDG, DAHLONEGA, GA 30533-6181
(706) 864-7272
(706) 864-7080
Mailing address
160 PROSPECTOR RDG, DAHLONEGA, GA 30533-6181
(706) 864-7272
(706) 864-7080
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
043118
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10050810
AMERIGROUP
GA
01
—
325964
WELLCARE
GA
01
—
52876062003
BCBS
GA
05
—
856357016A
—
GA
Enumeration date
09/21/2007
Last updated
09/06/2018
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