National Provider Identifier Database

GWINNETT ENDOSCOPY CENTER PC
Endoscopy


Contact Information

GWINNETT ENDOSCOPY CENTER, PC
301 PHILIP BLVD
SUITE B
LAWRENCEVILLE, GA30046-8745
Phone: 770-822-5562
Fax: 770-338-0510
Website:
Specialty Taxonomy Code
* Endoscopy 261QE0800X

* Indicates primary specialty

NPI Profile & details for GWINNETT ENDOSCOPY CENTER, PC

NPI Number 1194761908
Legal business name
LBN
GWINNETT ENDOSCOPY CENTER, PC
Authorized official JANA BAKER - (ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 06/21/2006
Last updated 08/24/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • GA Medicaid: 00587298A

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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