CLAYTON OUTPATIENT SURGICAL CENTER
Surgery Yellow Pages
Jonesboro, Georgia
Provider NPI: 1538166012
Organization Information:Organization Name: CLAYTON OUTPATIENT SURGICAL CENTER
Practice Location:
6911 TARA BLVD SUITE 104 JONESBORO, GA 30236 US
Tel: 770-477-9535 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
6911 TARA BLVD SUITE 104 JONESBORO, GA 30236 US
Tel: 770-477-9535 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 261QA1903X | Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical | GA | 031-070 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
RAILROAD MEDICARE | 490002632 | GA | 01 |
00649833A | GA | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin