Wellstar Douglas Surgical Associates, LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

WELLSTAR DOUGLAS SURGICAL ASSOCIATES, LLC

Practice address

6002 Professional Parkway
Suite 260
Douglasville, GA 30134

Phone

(770) 942-4822

Fax

(770) 942-5311

NPI assigned

Aug 2, 2006

Organization subpart

Yes

Parent organization

WELLSTAR HEALTH SYSTEM, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Nicole Ashe

Title

Executive Director of Finance

Phone

(770) 792-5261

Specialties & licenses 1

Addresses

Part of

NW Ga Nealth Systems in

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1477560340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6002 PROFESSIONAL PARKWAY",
            "address_2": "SUITE 260",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "30134",
            "telephone_number": "770-942-4822",
            "fax_number": "770-942-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6002 PROFESSIONAL PARKWAY",
            "address_2": "SUITE 260",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "30134",
            "telephone_number": "770-942-4822",
            "fax_number": "770-942-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR DOUGLAS SURGICAL ASSOCIATES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLSTAR HEALTH SYSTEM, INC.",
        "enumeration_date": "2006-08-02",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "ASHE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "770-792-5261",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.