Provider Demographics
NPI:1851626915
Name:SURGIPRO, INC
Entity Type:Organization
Organization Name:SURGIPRO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-904-4215
Mailing Address - Street 1:3725 LAWRENCEVILLE SUWANEE RD STE B1
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-2320
Mailing Address - Country:US
Mailing Address - Phone:770-904-4215
Mailing Address - Fax:
Practice Address - Street 1:3725 LAWRENCEVILLE SUWANEE RD STE B1
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2320
Practice Address - Country:US
Practice Address - Phone:770-904-4215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier