Organization
RIVERSIDE SURGERY CENTER, LLC
Active
Other names
RIVERSIDE SURGERY CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANA SUE TAYLOR (CREDENTIALING SPECIALIST)
(678) 426-2188
Entity
Organization
Contact information
Practice address
3556 RIVERSIDE DR, MACON, GA 31210-2509
(478) 475-9204
(478) 475-9572
Mailing address
3556 RIVERSIDE DR, MACON, GA 31210-2509
(678) 426-2188
(770) 874-8950
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
GA
Other
Enumeration date
06/18/2015
Last updated
07/13/2015
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