Provider Demographics
NPI:1427355080
Name:PINNACLE ORTHOPAEDICS SURGERY CENTER WOODSTOCK, LLC
Entity type:Organization
Organization Name:PINNACLE ORTHOPAEDICS SURGERY CENTER WOODSTOCK, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-926-6975
Mailing Address - Street 1:1505 STONEBRIDGE PKWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WOOSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189
Mailing Address - Country:US
Mailing Address - Phone:770-926-6975
Mailing Address - Fax:770-926-6925
Practice Address - Street 1:1505 STONEBRIDGE PKWY
Practice Address - Street 2:SUITE 120
Practice Address - City:WOOSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189
Practice Address - Country:US
Practice Address - Phone:770-926-6975
Practice Address - Fax:770-926-6925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical