Provider Demographics
NPI:1740504125
Name:MUS CENTERS OF GA, INC.
Entity type:Organization
Organization Name:MUS CENTERS OF GA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-344-8129
Mailing Address - Street 1:2950 STONE HOGAN CONNECTOR RD SW
Mailing Address - Street 2:SUITE B
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-2837
Mailing Address - Country:US
Mailing Address - Phone:404-344-8129
Mailing Address - Fax:404-997-6150
Practice Address - Street 1:2950 STONE HOGAN CONNECTOR RD SW
Practice Address - Street 2:SUITE B
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-2837
Practice Address - Country:US
Practice Address - Phone:404-344-8129
Practice Address - Fax:404-997-6150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060-415261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical