LAKE SPIVEY AMBULATORY SURGERY CARE LLC NPI 1487012480

NPI Information

NPI: 1487012480
Provider Name: LAKE SPIVEY AMBULATORY SURGERY CARE, LLC

Doing Business As: SPIVEY STATION SURGERY CENTER

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
7813 SPIVEY STATION BLVD
SUITE 100
JONESBORO, GA
ZIP 30236
Phone: (770) 268-6000
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LAKE SPIVEY AMBULATORY SURGERY CARE, LLC is an ambulatory surgical clinic center in Jonesboro, GA. LAKE SPIVEY AMBULATORY SURGERY CARE, LLC NPI is 1487012480. The provider is registered as an organization entity type.
The provider Is Doing Business As Spivey Station Surgery Center.

The provider's business location address is:

7813 SPIVEY STATION BLVD
SUITE 100
JONESBORO, GA
ZIP 30236-900
Phone: (770) 268-6000

The provider's authorized official is Christopher Doan .
The authorized official title is Chief Compliance Counsel and has the following contact phone number (909) 235-4307.

The enumeration date for this NPI number is 2/4/2016 and was last updated on 2/4/2016.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	031127	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	111125ASCA	MEDICARE OSCAR/CERTIFICATION	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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