Organization
SGI SURGICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE INGRAM (CSA)
(770) 354-6940
Entity
Organization
Contact information
Practice address
65 MOTE CROSSING RD, COVINGTON, GA 30016-5253
(770) 354-6940
(404) 671-9110
Mailing address
PO BOX 516, PORTERDALE, GA 30070-0516
(770) 354-6940
(404) 671-9110
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
3135
GA
Other
Enumeration date
05/27/2010
Last updated
05/27/2010
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