Provider Demographics
NPI:1437527363
Name:SURGEON'S CHOICE SURGICAL ASSISTING LLC
Entity type:Organization
Organization Name:SURGEON'S CHOICE SURGICAL ASSISTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:FLENEURY
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:770-265-1432
Mailing Address - Street 1:2300 BETHELVIEW RD
Mailing Address - Street 2:STE 110 #197
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-9475
Mailing Address - Country:US
Mailing Address - Phone:770-265-1432
Mailing Address - Fax:678-771-8220
Practice Address - Street 1:2300 BETHELVIEW RD
Practice Address - Street 2:STE 110 #197
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-9475
Practice Address - Country:US
Practice Address - Phone:770-265-1432
Practice Address - Fax:678-771-8220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-09
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty