Georgia Urology Gwinnett Asc

NPI 1083851497 - Clinic/Center - 261QA1903X

NPI Details
NPI 1083851497
Enumeration Date 01/07/2009
Last Updated 01/23/2015
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name MARK A MARK
Position MANAGING PARTNER
Phone (770) 979-9427
Fax (770) 972-3846
Practice Location
720 OLD SNELLVILLE HWY
SUITE 100
LAWRENCEVILLE GA, 30044-6216, US
Phone (770) 979-9427
Fax (770) 972-3846
Business Location
1930 BRANNAN RD
MCDONOUGH GA, 30253-4310, US
Phone (678) 284-4040
Fax (678) 284-4076
Toxanomy
Taxonomy Code 261QA1903X
License State
License Number
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According to our database, Georgia Urology Gwinnett Asc NPI is 1083851497, taxonomy code is 261QA1903X Georgia Urology Gwinnett Asc physically located at 720 Old Snellville Hwy, Lawrenceville GA, 30044-6216. NPI Number 1033115704 has the healthcare provider type.

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1083851497 NPI number is provided on an as is basis without warranty of any kind. 1083851497 is maintained by the National Plan & Provider Enumeration System. The contents of Georgia Urology Gwinnett Asc are for informational purposes only.