ICON SURGICAL NPI 1255003455

NPI Information

ICON SURGICAL is a surgical physician assistant in Mableton, GA. ICON SURGICAL NPI is 1255003455. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Icon Surgical.

The provider's business location address is:

268 SAINT PATRICK DR SW
MABLETON, GA
ZIP 30126-627
Phone: (678) 825-5397
Fax: (678) 426-6243

The provider's authorized official is Pamela Clay .
The authorized official title is Administrator and has the following contact phone number (888) 265-9908.

The enumeration date for this NPI number is 10/5/2021 and was last updated on 3/1/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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