Provider Demographics
NPI:1427396498
Name:EASTMAN SURGICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:EASTMAN SURGICAL ASSOCIATES, LLC
Other - Org Name:EASTMAN SURGICAL ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-448-4050
Mailing Address - Street 1:901 GRIFFIN AVE
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-6720
Mailing Address - Country:US
Mailing Address - Phone:478-448-4000
Mailing Address - Fax:
Practice Address - Street 1:829 PLAZA AVE
Practice Address - Street 2:
Practice Address - City:EASTMAN
Practice Address - State:GA
Practice Address - Zip Code:31023-6757
Practice Address - Country:US
Practice Address - Phone:478-448-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty