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Organization

IPC DALTON ASC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSHUA LIDELLE HARE DO (MEDICAL DIRECTOR)
(706) 847-0826
Entity
Organization

Contact information

Practice address
1502 DUG GAP RD, DALTON, GA 30720-5004
(706) 847-0826
(706) 529-9850
Mailing address
1502 DUG GAP RD, DALTON, GA 30720-5004
(706) 847-0826
(706) 529-9850

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
03/18/2025
Last updated
03/18/2025
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