Organization
AMICABLE SURGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WASANA J PHOUANGMALAY (CSFA)
(404) 435-3216
Entity
Organization
Contact information
Practice address
5665 PEACHTREE DUNWOODY RD, ATLANTA, GA 30342-1764
(678) 843-7001
Mailing address
137 SOUTH AVE, JONESBORO, GA 30236-4948
(404) 435-3216
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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