Organization
RESURGIA HEALTH SOLUTIONS PC
Active
Parent organization
RESURGIA HEALTH SOLUTIONS PC
Other names
Resurgia Fayetteville
Organization subpart
Yes
Provider details
NPI number
Legal business name
RESURGIA HEALTH SOLUTIONS PC
Authorized official
KEVIN CHARLES (GENERAL MANAGER)
(404) 445-5304
Entity
Organization
Contact information
Practice address
1233 HIGHWAY 54 W STE 130, FAYETTEVILLE, GA 30214-4542
(404) 445-5304
(404) 445-5173
Mailing address
1100 PEACHTREE ST NE STE 200, ATLANTA, GA 30309-4829
(404) 445-5304
(404) 445-5173
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003239762A
—
GA
Enumeration date
09/06/2021
Last updated
09/06/2021
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