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BUCKHEAD SURGICAL ASSOCIATES LLC NPI 1972843084


NPI Information

NPI: 1972843084
Provider Name: BUCKHEAD SURGICAL ASSOCIATES LLC
Classification: Surgery - 208600000X
Entity Type: Organization

CLIA Number: 11D2243334

Address:
2061 PEACHTREE RD NE
SUITE 300
ATLANTA, GA
ZIP 30309
Phone: (404) 350-7955
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BUCKHEAD SURGICAL ASSOCIATES LLC is a surgery in Atlanta, GA. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. BUCKHEAD SURGICAL ASSOCIATES LLC NPI is 1972843084. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2061 PEACHTREE RD NE
SUITE 300
ATLANTA, GA
ZIP 30309-427
Phone: (404) 350-7955
Fax: (404) 350-9115

The provider's authorized official is J. Dewayne Colquitt .
The authorized official title is Owner/m.d. and has the following contact phone number (404) 350-7955.

The CLIA number assigned to this NPI record is 11D2243334 - other - php/iop with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/26/2013 and was last updated on 1/14/2014.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgery41097GEORGIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
120270G4314MEDICARE PINGEORGIA

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

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