Provider Demographics
NPI:1417295528
Name:ATLANTA GENERAL AND BARIATRIC SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:ATLANTA GENERAL AND BARIATRIC SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-232-2911
Mailing Address - Street 1:6300 HOSPITAL PKWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-1828
Mailing Address - Country:US
Mailing Address - Phone:770-232-2911
Mailing Address - Fax:678-681-1730
Practice Address - Street 1:6300 HOSPITAL PKWY
Practice Address - Street 2:SUITE 150
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-1828
Practice Address - Country:US
Practice Address - Phone:770-232-2911
Practice Address - Fax:678-681-1730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical