Organization
GASTROENTEROLOGY ENDOSCOPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEASA BURNS (PRACTICE ADMINISTRATOR)
(404) 881-8253
Entity
Organization
Contact information
Practice address
550 PEACHTREE ST NE, SUITE 1750, ATLANTA, GA 30308-2263
(404) 881-8800
(404) 523-6791
Mailing address
550 PEACHTREE ST NE, SUITE 1750, ATLANTA, GA 30308-2263
(404) 881-8800
(404) 523-6791
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
060-149
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000783813A
—
GA
Enumeration date
03/26/2007
Last updated
10/04/2012
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