NPI age
20 years
Enumerated 2005-06-30
● Active Type 2 · Organization
Clayton Outpatient Surgical Center
Clayton Outpatient Surgical Center 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
Kalish
Medical Director
Last NPPES update
2010-08-12
Source: monthly bulk 2026-05
How this organization compares
Across 602 active clinic/center providers in Georgia.
NPI age
20 years
↑ 5 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2005 → 2026
2005-06Enumerated in NPPES
2005
2026
Where they practice
Primary practice location
6911 Tara Blvd, Suite 104
Jonesboro, GA 302361503
Mailing address
6911 Tara Blvd, Suite 104
Jonesboro, GA 302361503
Authorized official
Stanley Kalish, DPM
Medical Director
📞 7704779535
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Myrna Gacusan Nurse Practitioner NPI 1174976088
- Stanley Kalish, DPM Podiatrist NPI 1811994379
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00649833A | |
| 01 (GA) | 490002632 | RAILROAD MEDICARE |
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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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.