Organization
CARROLLTON SURGICAL GROUP, P. A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAN M ZEIS (PRACTICE ADMINISTRATOR)
(770) 537-4702
Entity
Organization
Contact information
Practice address
204 ALLEN MEMORIAL DR, SUITE 103, BREMEN, GA 30110-2047
(770) 537-4702
(770) 537-4539
Mailing address
204 ALLEN MEMORIAL DR, SUITE 103, BREMEN, GA 30110-2047
(770) 537-4702
(770) 537-4539
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55001589A
—
GA
Enumeration date
06/09/2006
Last updated
08/22/2020
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