GWINNETT CLINIC LTD NPI 1013085513

NPI Information

NPI: 1013085513
Provider Name: GWINNETT CLINIC, LTD
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 11D1064729

Address:
4870 LAWRENCEVILLE HWY
TUCKER, GA
ZIP 30084
Phone: (770) 496-1429
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GWINNETT CLINIC, LTD is a multi-specialty clinic center in Tucker, GA. GWINNETT CLINIC, LTD NPI is 1013085513. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4870 LAWRENCEVILLE HWY
TUCKER, GA
ZIP 30084-952
Phone: (770) 496-1429
Fax: (770) 270-5854

The provider's authorized official is Deep Shah .
The authorized official title is Authorized Official and has the following contact phone number (770) 995-3300.

The CLIA number assigned to this NPI record is 11D1064729 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/1/2006 and was last updated on 1/25/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	173000000X	Legal Medicine		No
2	207Q00000X	Family Medicine		No
3	207R00000X	Internal Medicine		No
4	363L00000X	Nurse Practitioner		No
5	261QM1300X	Clinic/Center	Multi-Specialty	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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