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Organization

THE ROME ENDOSCOPY CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEITH BALDWIN (ADMINISTRATOR)
(706) 292-3036
Entity
Organization

Contact information

Practice address
11 JOHN MADDOX DR NW, ROME, GA 30165-1413
(706) 295-3992
Mailing address
11 JOHN MADDOX DR NW, ROME, GA 30165-1413
(706) 295-3992

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
057045
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000447576C
GA
Enumeration date
04/12/2006
Last updated
05/06/2014
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