Organization
GEORGIA SURGICAL STAFFING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALAN COUCH CRNFA (PRESIDENT)
(770) 312-0477
Entity
Organization
Contact information
Practice address
78 DAWSON VILLAGE WAY N, SUITE 140, PMB-13, DAWSONVILLE, GA 30534-7168
(770) 312-0477
Mailing address
78 DAWSON VILLAGE WAY N, SUITE 140, PMB-13, DAWSONVILLE, GA 30534-7168
(770) 312-0477
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN054026
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52821397
BCBS PROVIDER NUMBER
GA
Enumeration date
11/28/2006
Last updated
04/08/2014
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