Organization
URGENT CARE BANKS CROSSING LLC
Active
Other names
Commerce Surgical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA A BROOKSHIRE (OFFICE MANAGER)
(706) 336-0074
Entity
Organization
Contact information
Practice address
415 B POTTERY FACTORY DRIVE, COMMERCE, GA 30529
(706) 336-0074
(706) 336-0079
Mailing address
P.O. BOX 1055, COMMERCE, GA 30529
(706) 336-0074
(706) 336-0079
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
049138
GA
208600000X
Surgery Physician
049138
GA
208D00000X
General Practice Physician
Primary
—
GA
208VP0000X
Pain Medicine Physician
049138
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000771999H
—
GA
01
—
1033127899
NPI
GA
01
—
1497763254
NPI
GA
05
—
971545216B
—
GA
Enumeration date
05/29/2008
Last updated
12/28/2009
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