Basic Information
| Provider Information | |||||||||
| NPI: | 1871841544 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SPALDING ENDOSCOPY CENTER, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 226 E COLLEGE ST | ||||||||
| Address2: | SUITE A | ||||||||
| City: | GRIFFIN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302244348 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6789871490 | ||||||||
| FaxNumber: | 6789871491 | ||||||||
| Practice Location | |||||||||
| Address1: | 226 E COLLEGE ST | ||||||||
| Address2: | SUITE A | ||||||||
| City: | GRIFFIN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302244348 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6789871490 | ||||||||
| FaxNumber: | 6789871491 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2012 | ||||||||
| LastUpdateDate: | 08/28/2012 | ||||||||
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| AuthorizedOfficialLastName: | MORRIS | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4048887575 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.