GEORGIA LITHOTRIPSY AND LASER CENTER NPI 1386739498

NPI Information

NPI: 1386739498
Provider Name: GEORGIA LITHOTRIPSY AND LASER CENTER
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
120 TRINITY PL
ATHENS, GA
ZIP 30607
Phone: (706) 543-2718
Get Directions

GEORGIA LITHOTRIPSY AND LASER CENTER is an ambulatory surgical clinic center in Athens, GA. GEORGIA LITHOTRIPSY AND LASER CENTER NPI is 1386739498. The provider is registered as an organization entity type.

The provider's business location address is:

120 TRINITY PL
ATHENS, GA
ZIP 30607-100
Phone: (706) 543-2718
Fax: (706) 353-3709

The provider's authorized official is David C Allen .
The authorized official title is President and has the following contact phone number (706) 543-2718.

The enumeration date for this NPI number is 10/4/2006 and was last updated on 11/5/2008.

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	License Number	License State	Primary
1	261QR0200X	Clinic/Center	Radiology			No
2	261QL0400X	Clinic/Center	Lithotripsy	029-044	GEORGIA	No
3	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00451316A	MEDICAID	GEORGIA
2	590	OTHER	GEORGIA	BLUE CROSS BLUE SHIELD
3	111026ASCA	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	ASC
4	581596177001	OTHER	GEORGIA	CHAMPUS
5	P00028010	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	RAILROAD MEDICARE

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: 4/28/2024

NPI Synchronization or Removal

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