NPI age
19 years
Enumerated 2006-08-29
● Active Type 2 · Organization
Southlake Ambulatory Surgery Center, Lllp
Southlake Ambulatory Surgery Center, Lllp is 1 of 602 clinic/center organizations in Georgia.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
McLain
Executive Vp & Coo
Last NPPES update
2013-07-25
Source: monthly bulk 2026-05
How this organization compares
Across 602 active clinic/center providers in Georgia.
NPI age
19 years
↑ 4 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-08Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
7813 Spivey Station Blvd, Suite 100
Jonesboro, GA 302360000
Mailing address
11 Upper Riverdale Rd Sw
Riverdale, GA 302742615
Authorized official
John R McLain
Executive Vp & Coo
📞 7709918000
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Minh Tang, PAA Anesthesiologist Assistant NPI 1003366873
- Jana Yates Nurse Practitioner NPI 1194545632
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00973046A | |
| 05 (GA) | 306743 |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Spivey Station Surgery Center
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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