Organization
MARIETTA OUTPATIENT SURGERY, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM GREGORY SWINNEY (VP)
(972) 789-2877
Entity
Organization
Contact information
Practice address
780 CANTON RD NE, SUITE 100, MARIETTA, GA 30060-7241
(770) 422-1579
(770) 422-1057
Mailing address
780 CANTON RD NE, SUITE 100, MARIETTA, GA 30060-7241
(770) 422-1579
(770) 422-1057
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
033163
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00354593A
—
GA
Enumeration date
04/18/2006
Last updated
02/15/2018
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