| Southern Cross Surgery Center, Llc | |
|
1301 Sigman Rd Ne Suite 120 Conyers GA 30012-3812 | |
| (770) 760-9360 | |
| Not Available |
| Full Name | Southern Cross Surgery Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1301 Sigman Rd Ne, Conyers, Georgia |
| Authorized Official Name and Position | R. L. Talley (MD/OWNER) |
| Authorized Official Contact | 7707609360 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Cross Surgery Center, Llc 1301 Sigman Rd Ne Suite 120 Conyers GA 30012-3812 Ph: (770) 760-9360 | Southern Cross Surgery Center, Llc 1301 Sigman Rd Ne Suite 120 Conyers GA 30012-3812 Ph: (770) 760-9360 |
| NPI Number | 1225321508 |
|---|---|
| Provider Enumeration Date | 05/19/2011 |
| Last Update Date | 04/29/2015 |
| Medicare PECOS PAC ID | 4789854324 |
|---|---|
| Medicare Enrollment ID | O20110908002253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225321508 | NPI | - | NPPES |
| 202G490818 | Other | GA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 29957 (Georgia) | Secondary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | 029957 (Georgia) | Primary |
Internal Medicine Associates Of Rockdale Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1301 Wellbrook Circle, Conyers, GA 30012 Phone: 770-922-3023 Fax: 770-929-1016 | |
Family & Occupational Medicine Of Conyers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1907 Crescent Moon Dr Ne, Conyers, GA 30012 Phone: 404-358-3427 | |
Conyers Internal Medicine Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1380 Milstead Ave Ne, Ste C, Conyers, GA 30012 Phone: 770-922-7000 | |
Kimble Care Medical Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3340 Oak Dr Se, Conyers, GA 30013 Phone: 770-881-7100 | |
Aylo Health, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1101 Nortec Dr Se, Conyers, GA 30013 Phone: 678-374-7514 Fax: 678-374-7517 | |
Georgeia Internal Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1275 Parker Rd Se, Conyers, GA 30094 Phone: 770-929-8100 Fax: 770-929-3485 | |
Prime Care & Pathology Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1050 Green St Se, Conyers, GA 30012 Phone: 770-648-7226 Fax: 770-648-7211 |