Organization
MIDTOWN SURGICAL ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUANE PRICKETT (CEO)
(404) 872-8799
Entity
Organization
Contact information
Practice address
95 COLLIER RD NW, SUITE 4025, ATLANTA, GA 30309-1796
(404) 872-8799
(404) 874-3544
Mailing address
PO BOX 79105, ATLANTA, GA 30357-7105
(404) 872-8799
(404) 874-3544
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
RN107268
GA
163WR0006X
Registered Nurse First Assistant
RN147341
GA
163WR0006X
Registered Nurse First Assistant
RN150639
GA
163WR0006X
Registered Nurse First Assistant
Primary
RN173288
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528113370
NPI
GA
01
—
1669538245
NPI
GA
01
—
1770633737
NPI
GA
01
—
1801946876
NPI
GA
01
—
52058526
BCBS ID #
GA
01
—
52703540
BCBS ID #
GA
01
—
52805990
BCBS ID #
GA
Enumeration date
02/07/2007
Last updated
07/03/2008
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