GWINNETT ENDOSCOPY CENTER PC NPI 1194761908

NPI Information

NPI: 1194761908
Provider Name: GWINNETT ENDOSCOPY CENTER, PC
Classification: Clinic/Center - 261QE0800X
Entity Type: Organization

Specialization: Endoscopy

Address:
301 PHILIP BLVD
SUITE B
LAWRENCEVILLE, GA
ZIP 30046
Phone: (770) 822-5562
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GWINNETT ENDOSCOPY CENTER, PC is an endoscopy clinic center in Lawrenceville, GA. GWINNETT ENDOSCOPY CENTER, PC NPI is 1194761908. The provider is registered as an organization entity type.

The provider's business location address is:

301 PHILIP BLVD
SUITE B
LAWRENCEVILLE, GA
ZIP 30046-745
Phone: (770) 822-5562
Fax: (770) 338-0510

The provider's authorized official is Jana Baker .
The authorized official title is Administrator and has the following contact phone number (404) 888-7575.

The enumeration date for this NPI number is 6/21/2006 and was last updated on 8/24/2011.

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
1	261QE0800X	Clinic/Center	Endoscopy			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	X17825	MEDICARE UPIN	GEORGIA
2	111055ASCA	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA
3	00587298A	MEDICAID	GEORGIA

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

NPI Synchronization or Removal

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