PA-C SURGICAL ASSIST, LLC – NPI #1801413174
Clinic/Center

PA-C SURGICAL ASSIST, LLC is an AHC clinic located in DECATUR, GA. NPPES has assigned the NPI number 1801413174 to PA-C SURGICAL ASSIST, LLC on July 02, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PA-C SURGICAL ASSIST, LLC below.

NPI Profile for
PA-C SURGICAL ASSIST, LLC

NPI Number
1801413174
Enumeration Date

(about 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PA-C SURGICAL ASSIST, LLC
Primary location
520 W PONCE LEON AVE #1706
DECATUR, GA 30030
Phone: (404) 907-3292 Fax:
Mailing address
PO BOX 1706
DECATUR, GA 30031-1706
Phone: (404) 907-3292 Fax:
Organization Subpart
No
Authorized Official
TIFFANY GIBBERT
OWNER
Phone: (404) 907-3292
Updated
Certification Date
Jul 02, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.