NPI 1013601517

Asc of Baucom & Mina Derm Surgery Johns Creek LLC

Organisation Ambulatory Surgical Clinic/Center Johns Creek, GA

Practice location

Address: 10750 Medlock Bridge Rd STE 102, Johns Creek, GA 30097-1705
Phone: (470) 545-2124
Fax: (404) 844-0499
Mailing address: 5555 Peachtree Dunwoody Rd STE 206, Atlanta, GA 30342-1711

Authorised official

Name: Mark F Baucom
Title: Owner
Phone: (404) 844-0496

Registered specialties

Ambulatory Surgical Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QA1903X

Other Clinic/Center providers in Georgia →

Registry record

NPI: 1013601517
Entity type: Organization
NPI issued: 7 Jun 2023
Record last updated: 13 Dec 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.