Organization
ADVANCED LAPAROSCOPIC SURGERY ASSOCIATES OF GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIHESHA LONEE WILSON MD (PRESIDENT/CEO)
(678) 565-8753
Entity
Organization
Contact information
Practice address
150 COUNTRY CLUB DR, SUITE 101, STOCKBRIDGE, GA 30281-7344
(678) 565-8753
(678) 565-8902
Mailing address
909 EAGLES LANDING PKWY, SUITE 140 BOX 132, STOCKBRIDGE, GA 30281-7247
(678) 565-8753
(678) 565-8902
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
054703
GA
Other
Enumeration date
01/13/2006
Last updated
08/22/2020
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