Provider Demographics
NPI:1922033802
Name:JOHNS CREEK SURGERY PC
Entity Type:Organization
Organization Name:JOHNS CREEK SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-232-2911
Mailing Address - Street 1:6920 MCGINNIS FERRY RD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1258
Mailing Address - Country:US
Mailing Address - Phone:770-232-2911
Mailing Address - Fax:770-232-2996
Practice Address - Street 1:6920 MCGINNIS FERRY RD
Practice Address - Street 2:SUITE 340
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1258
Practice Address - Country:US
Practice Address - Phone:770-232-2911
Practice Address - Fax:770-232-2996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7761Medicare PIN