Organization
NORTH GEORGIA OUTPATIENT SURGERY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HERBERT E. KOSMAHL D.P.M. (PRESIDENT AND MEDICAL DIRECTOR)
(706) 629-1852
Entity
Organization
Contact information
Practice address
795 RED BUD RD NE, CALHOUN, GA 30701-1966
(706) 629-1852
(706) 629-8004
Mailing address
795 RED BUD RD NE, CALHOUN, GA 30701-1966
(706) 629-1852
(706) 629-8004
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
064-078
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00586506A
—
GA
01
—
51001641-002
BLUE CROSS BLUE SHIELD
GA
01
—
590008544
RAILROAD MEDICARE
GA
Enumeration date
12/20/2006
Last updated
02/05/2016
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