Provider Demographics
NPI:1952141756
Name:SUMMIT ENDOSCOPY CENTER
Entity type:Organization
Organization Name:SUMMIT ENDOSCOPY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF RCNIS
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-603-3543
Mailing Address - Street 1:3280 HOWELL MILL RD NW STE T100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4122
Mailing Address - Country:US
Mailing Address - Phone:404-603-3543
Mailing Address - Fax:404-350-8795
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:404-603-3543
Practice Address - Fax:404-455-9548
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMIT ENDOSCOPY CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-29
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical