Organization
INNOVATIVE AMBULATORY SURGERY CENTER
Active
Organization
INNOVATIVE AMBULATORY SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSCAR JAMESON STOKES M.D. (CHIEF EXECUTIVE OFFICER)
(323) 316-8090
Entity
Organization
Contact information
Practice address
1300 UPPER HEMBREE RD, BUILDING 100, SUITE B, ROSWELL, GA 30076-0927
(888) 232-8724
Mailing address
129 MORNING VISTA DR, MADISON, AL 35758-8008
(323) 316-8090
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
066905
AL
Other
Enumeration date
11/11/2012
Last updated
11/11/2012
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