Organization
NORTHWEST GEORGIA SURGICAL SPECIALISTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL FRANKLIN PRUITT MD (PRESIDENT)
(770) 547-0852
Entity
Organization
Contact information
Practice address
4450 CALIBRE XING NW, SUITE 1130, ACWORTH, GA 30101-4103
(770) 547-0852
Mailing address
4450 CALIBRE XING NW, SUITE 1130, ACWORTH, GA 30101-4103
(770) 547-0852
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
041931
GA
Other
Enumeration date
09/16/2008
Last updated
09/16/2008
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