Organization
ORTHO ATLANTA SURGERY CENTER OF FAYETTEVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN YOUNG (ADMINISTRATOR)
(678) 673-5108
Entity
Organization
Contact information
Practice address
1265 HIGHWAY 54 W STE 103, FAYETTEVILLE, GA 30214-4537
(678) 673-5108
Mailing address
1265 HIGHWAY 54 W STE 103, FAYETTEVILLE, GA 30214-4537
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
056-HOS-001
GA
Other
Enumeration date
06/01/2015
Last updated
06/01/2015
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