Organization
COLISEUM SAME DAY SURGERY CENTER LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAY BUXTON (ADMINISTRATOR)
(478) 742-1403
Entity
Organization
Contact information
Practice address
340 HOSPITAL DR, BLDG E, MACON, GA 31217-3838
(478) 742-1403
(478) 742-7018
Mailing address
PO BOX 6154, MACON, GA 31208-6154
(478) 742-1403
(478) 742-7018
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
011-188
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00354263A
—
GA
01
—
490004496
RAILROAD MCARE PROVIDER
—
Enumeration date
06/24/2005
Last updated
08/24/2021
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