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Organization

ADVANCED SURGICAL SPECIALISTS OF NORTHEAST GEORGIA, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KERMIE LENARD ROBINSON M.D., F.A.C.S. (OWNER, SOLE PROPRIETER)
(678) 413-2182
Entity
Organization

Contact information

Practice address
1359 MILSTEAD RD NE, SUITE 203, CONYERS, GA 30012-3865
(678) 413-2182
(678) 413-2184
Mailing address
1359 MILSTEAD RD NE, SUITE 203, CONYERS, GA 30012-3865
(678) 413-2182
(678) 413-2184

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
033440
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000458092C
GA
01
DE9275
MEDICARE RAILROAD GROUP
GA
Enumeration date
11/13/2007
Last updated
09/05/2008
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