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JACEK LYSZKOWICZ MD PC NPI 1598719007


NPI Information

NPI: 1598719007
Provider Name: JACEK LYSZKOWICZ MD PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1366 WELLBROOK CIR NE
SUITE B
CONYERS, GA
ZIP 30012
Phone: (770) 922-9622
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JACEK LYSZKOWICZ MD PC is a family medicine in Conyers, GA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. JACEK LYSZKOWICZ MD PC NPI is 1598719007. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1366 WELLBROOK CIR NE
SUITE B
CONYERS, GA
ZIP 30012-872
Phone: (770) 922-9622
Fax: (770) 922-9620

The provider's authorized official is Jacek Eustachy Lyszkowicz .
The authorized official title is Owner and has the following contact phone number (770) 922-9622.

The enumeration date for this NPI number is 5/20/2006 and was last updated on 4/24/2008.


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
1207Q00000XFamily Medicine047113GEORGIAYes

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 Other Provider Identifier Issuer
1F46010MEDICARE UPINGEORGIA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.