SOUTHERN ENDOSCOPY SUITE, LLC; NPI #1215986609

Contact Information

SOUTHERN ENDOSCOPY SUITE, LLC

763 OLD NORCROSS RD
LAWRENCEVILLE, GA 30045-4317

Phone: 678-985-2000
Fax: 678-985-1999
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Endoscopy	261QE0800X
Ambulatory Surgical	261QA1903X	49	Ambulatory Surgical Center

Indicates primary specialty

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NPI Profile & details for SOUTHERN ENDOSCOPY SUITE, LLC

NPI Number 1215986609

LBN Legal business name SOUTHERN ENDOSCOPY SUITE, LLC

Authorized official MARK KUKLER - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/10/2006

Last updated 11/28/2017 - About 9 years ago

Identifiers

License #

067-200

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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SOUTHERN ENDOSCOPY SUITE, LLC

Contact Information

Specialty

Endoscopy

Ambulatory Surgical

NPI Profile & details for SOUTHERN ENDOSCOPY SUITE, LLC

Reviews for SOUTHERN ENDOSCOPY SUITE, LLC