Organization
SOUTHERN BONE & JOINT AMBULATORY SURGICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
5673 PEACHTREE DUNWOODY RD STE 800, ATLANTA, GA 30342-1776
(404) 255-5595
(404) 252-2780
Mailing address
1755 HIGHWAY 34 E STE 1100, NEWNAN, GA 30265-3184
(707) 252-7510
(404) 252-2780
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
582430839
TAX ID
GA
Enumeration date
11/09/2006
Last updated
11/06/2023
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