Organization
SOUTHEASTERN SURGICAL CENTER
Active
Organization
SOUTHEASTERN SURGICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. H RON H DAVIDSON (EXECUTIVE ADMINISTRATOR)
(404) 459-3473
Entity
Organization
Contact information
Practice address
1100 JOHNSON FERRY ROAD, SUITE 200, ATLANTA, GA 30342
(404) 257-1900
(404) 257-0792
Mailing address
1100 JOHNSON FERRY ROAD, SUITE 200, ATLANTA, GA 30342
(404) 257-1900
(404) 257-0792
Taxonomy
Speciality
Code
Description
License number
State
261QA0006X
Ambulatory Fertility Facility
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060079
PERMIT
GA
Enumeration date
12/04/2006
Last updated
08/03/2011
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