Organization
GASTROINTESTINAL DIAGNOSTIC ENDOSCOPY WOODSTOCK, LLC
Active
Other names
Town Lake Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY L JONES (PRACTICE ADMINISTRATION)
(678) 741-2317
Entity
Organization
Contact information
Practice address
118 MILL ST STE 100, WOODSTOCK, GA 30188-4880
(770) 226-9070
(770) 226-8863
Mailing address
2550 WINDY HILL RD SE STE 302, MARIETTA, GA 30067-8655
(678) 741-5000
(678) 741-2301
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
028-451
GA
261QE0800X
Endoscopy Clinic/Center
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—
Other
Enumeration date
06/28/2011
Last updated
12/03/2025
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