Organization
PIEDMONT REGIONAL SURGICAL
Active
Other names
PIEDMONT REGIONAL SURGICAL ASSOCIATES, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ALISHA OVERMAN (OFFICE MANAGER)
(478) 452-1024
Entity
Organization
Contact information
Practice address
750 N COBB ST STE 130, MILLEDGEVILLE, GA 31061-7168
(478) 452-1024
(478) 452-0447
Mailing address
PO BOX 1473, MILLEDGEVILLE, GA 31059-1473
(478) 452-1024
(478) 452-0447
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP6491
MEDICARE GROUP#
GA
Enumeration date
09/12/2007
Last updated
05/18/2011
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