Organization
OPHTHALMIC SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH CERAVOLO MD (PRESIDENT)
(706) 323-8127
Entity
Organization
Contact information
Practice address
1240 BROOKSTONE CENTRE PKWY, COLUMBUS, GA 31904-2954
(706) 323-8127
(706) 596-4849
Mailing address
1240 BROOKSTONE CENTRE PKWY, COLUMBUS, GA 31904-2954
(706) 323-8127
(706) 596-4849
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
06/27/2019
Last updated
11/21/2019
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