Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Icon Surgical

Organization Surgical Physician Assistant · NPI 1255003455

Icon Surgical is a Surgical Physician Assistant in Mableton, Georgia. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

268 Saint Patrick Dr SW
Mableton, GA 30126-1627
Phone: (678) 825-5397
Fax: (678) 426-6243
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X

Record details

NPI number1255003455
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Pamela Clay — Administrator · (888) 265-9908
Other names Icon Surgical; Icon Surgical
NPI enumeratedOctober 5, 2021
Last updated in NPPESMarch 1, 2024
Certification dateMarch 1, 2024
Mailing address268 Saint Patrick Dr Sw, Mableton, GA 30126-1627