Organization
G.I.ENDOSCOPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY R PRAKASH M.D. (PRESIDENT)
(770) 996-5959
Entity
Organization
Contact information
Practice address
6555 PROFESSIONAL PL, SUITE B, RIVERDALE, GA 30274-4903
(770) 996-5959
Mailing address
6555 PROFESSIONAL PL, SUITE B, RIVERDALE, GA 30274-4903
(770) 996-5959
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/11/2006
Last updated
03/05/2013
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