Provider Demographics
NPI:1083243844
Name:DULUTH SURGERY CENTER
Entity Type:Organization
Organization Name:DULUTH SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUNUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-695-6747
Mailing Address - Street 1:6620 MCGINNIS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-1542
Mailing Address - Country:US
Mailing Address - Phone:678-205-8400
Mailing Address - Fax:770-573-6004
Practice Address - Street 1:6620 MCGINNIS FERRY RD
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-1542
Practice Address - Country:US
Practice Address - Phone:678-205-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center