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Contact Information

NORTHLAKE PHYSICIAN PRACTICE NETWORK INC
1459 MONTREAL RD
408
TUCKER, GA30084-6900
 Phone: 770-938-3440
 Fax: 770-938-3443
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical Oncology

2086X0206X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for NORTHLAKE PHYSICIAN PRACTICE NETWORK INC · (Female)

NPI # 1285672220
Status Active
Credentials
Entity Individual
Enumeration date 06/03/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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