NORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC LLC NPI 1144719311

NPI Information

NPI: 1144719311
Provider Name: NORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC, LLC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 11D2169857

Address:
1240 JESSE JEWELL PKWY SE STE 500
GAINESVILLE, GA
ZIP 30501
Phone: (855) 709-4535
Get Directions

NORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC, LLC is a multi-specialty clinic center in Gainesville, GA. NORTHEAST GEORGIA DIAGNOSTIC ASSOCIATES AND CLINIC, LLC NPI is 1144719311. The provider is registered as an organization entity type.

The provider's business location address is:

1240 JESSE JEWELL PKWY SE STE 500
GAINESVILLE, GA
ZIP 30501-861
Phone: (855) 709-4535

The provider's authorized official is Jorge J Hernandez .
The authorized official title is Vp Admin Srvs./cco and has the following contact phone number (404) 851-6378.

The CLIA number assigned to this NPI record is 11D2169857 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 5/3/2018 and was last updated on 1/11/2023.

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
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

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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