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CARDIOVASCULAR GROUP NPI 1003140351


NPI Information

NPI: 1003140351
Provider Name: CARDIOVASCULAR GROUP
Classification: Physician Assistant - 363A00000X
Entity Type: Organization

CLIA Number: 11D2131392

Address:
755 WALTHER RD
LAWRENCEVILLE, GA
ZIP 30046
Phone: (678) 252-3707
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CARDIOVASCULAR GROUP is a physician assistant in Lawrenceville, GA. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. CARDIOVASCULAR GROUP NPI is 1003140351. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

755 WALTHER RD
LAWRENCEVILLE, GA
ZIP 30046-725
Phone: (678) 252-3707

The provider's authorized official is Mariah Wood Thaxton .
The authorized official title is Physician Assistant and has the following contact phone number (478) 457-7128.

The CLIA number assigned to this NPI record is 11D2131392 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/18/2009 and was last updated on 10/3/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician AssistantYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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