Provider Demographics
NPI:1639282932
Name:ATLANTA ENDOSCOPY CENTER
Entity Type:Organization
Organization Name:ATLANTA ENDOSCOPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:RAUSHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-296-1986
Mailing Address - Street 1:2665 N DECATUR RD
Mailing Address - Street 2:SUITE 545
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6149
Mailing Address - Country:US
Mailing Address - Phone:404-296-1986
Mailing Address - Fax:404-296-9890
Practice Address - Street 1:2665 N DECATUR RD
Practice Address - Street 2:SUITE 545
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6149
Practice Address - Country:US
Practice Address - Phone:404-296-1986
Practice Address - Fax:404-296-9890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GABP1897682OtherDEA# FOR DR. PARRISH
GAE86268Medicare UPIN