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NPI 1245623735
● Active Type 2 · Organization
Surgical Services
Specialist/Technologist, Other · Marietta, GA · NPI 1245623735
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Enumerated 2015 · 11 years on NPI
Surgical Services is 1 of 399 specialist/technologist, other organizations in Georgia.
NPI age
11 years
Enumerated 2015-03-09
Primary specialty
Specialist/Technologist, Other
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Phillip
Patient Account Manager
Last NPPES update
2015-03-09
Source: monthly bulk 2026-05
How this organization compares
Across 399 active specialist/technologist, other providers in Georgia.
NPI age
11 years
↑ 5 yr above median
Practice locations
1
0 secondary on file
NPI lifetime · 2015 → 2026
2015-03 Enumerated in NPPES
2015
2026
Where they practice
Primary practice location
4084 Audubon Dr
Marietta, GA 300682605
📞 7709854257 fax 7709854258
Mailing address
4084 Audubon Dr
Marietta, GA 300682605
📞 7709854257 fax 7709854258
Authorized official
Pam Phillip
Patient Account Manager
📞 7709854257
Individual providers at this organization
1 individual provider on file at this primary practice address.
Specialties
Specialist/Technologist, Other
Primary
A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting,...
GA license #1614 taxonomy 246ZC0007X
Practice context
Multi-provider organization.
1 individual provider on file at this primary address.
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How to verify this organization
Confirm the NPI on NPPES. The CMS registry is the system of record. Open NPPES →
Verify the organization is in good standing. Cross-check with the state's business registration and any applicable licensing boards.
Confirm payer enrollment if billing. NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.
Updated 2026-05-14
· Source: CMS NPPES bulk export. Praxis MD refreshes the directory monthly with weekly delta updates.
Independent public resource. Not affiliated with CMS, HHS, or NPPES. Not endorsed by the U.S. government.
NPI listing is not proof of active licensure or payer enrollment.