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GWINNETT CLINIC LTD NPI 1255342630


NPI Information

NPI: 1255342630
Provider Name: GWINNETT CLINIC, LTD
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 11D0993813

Address:
4397 ATLANTA HWY
LOGANVILLE, GA
ZIP 30052
Phone: (770) 554-0800
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GWINNETT CLINIC, LTD is a multi-specialty clinic center in Loganville, GA. GWINNETT CLINIC, LTD NPI is 1255342630. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4397 ATLANTA HWY
LOGANVILLE, GA
ZIP 30052-642
Phone: (770) 554-0800
Fax: (770) 554-0080

The provider's authorized official is Deep Shah .
The authorized official title is Authorized Official and has the following contact phone number (770) 995-3300.

The CLIA number assigned to this NPI record is 11D0993813 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/10/2006 and was last updated on 1/24/2023.


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
1173000000XLegal MedicineNo
2207Q00000XFamily MedicineNo
3207R00000XInternal MedicineNo
4363L00000XNurse PractitionerNo
5261QM1300XClinic/CenterMulti-SpecialtyYes

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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