National Provider Identifier Database

LAKESHORE TUBAL REVERSAL CENTER
Ambulatory Surgical


Contact Information

LAKESHORE TUBAL REVERSAL CENTER
2320 LIMESTONE PARKWAY
GAINESVILLE, GA30501
Phone: 877-588-5594
Fax: 770-531-0053
Website:
Specialty Taxonomy Code
* Ambulatory Surgical 261QA1903X

* Indicates primary specialty

NPI Profile & details for LAKESHORE TUBAL REVERSAL CENTER

NPI Number 1457425159
Legal business name
LBN
LAKESHORE TUBAL REVERSAL CENTER
Authorized official CECILIA BATES - (OFFICE MANAGER)
Entity Organization
Organization subpart No
Enumeration date 11/17/2006
Last updated 03/10/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: DEA AG5691452
  • GA License #: GA LIC 022231

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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