Organization
ISPM ASC AT COVINGTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBIN J FOWLER MD (OWNER)
(770) 929-9033
Entity
Organization
Contact information
Practice address
5303 ADAMS ST NE STE C, COVINGTON, GA 30014-6209
(678) 729-8590
(678) 729-8595
Mailing address
PO BOX 935100, ATLANTA, GA 31193-5100
(678) 729-8590
(678) 729-8595
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
11/19/2012
Last updated
11/21/2012
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