Provider Demographics
NPI:1417346594
Name:GEORGIA MICRO SURGERY
Entity Type:Organization
Organization Name:GEORGIA MICRO SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:TOMMYE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-352-3522
Mailing Address - Street 1:2061 PEACHTREE ROAD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1447
Mailing Address - Country:US
Mailing Address - Phone:404-352-3522
Mailing Address - Fax:404-601-1235
Practice Address - Street 1:2061 PEACHTREE RD NE
Practice Address - Street 2:SUITE 500
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1447
Practice Address - Country:US
Practice Address - Phone:404-352-3522
Practice Address - Fax:404-601-1235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty