Provider Demographics
NPI:1477917151
Name:WHITE OAK SURGERY CENTER
Entity Type:Organization
Organization Name:WHITE OAK SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:BROWNLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-252-7557
Mailing Address - Street 1:1665 HIGHWAY 34 E STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2404
Mailing Address - Country:US
Mailing Address - Phone:678-671-4807
Mailing Address - Fax:
Practice Address - Street 1:1665 HIGHWAY 34 E STE 200
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2404
Practice Address - Country:US
Practice Address - Phone:678-671-4807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-08
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA038-485261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical