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LAKESIDE OB/GYN AND PELVIC SURGERY LLC NPI 1720225410


NPI Information

NPI: 1720225410
Provider Name: LAKESIDE OB/GYN AND PELVIC SURGERY, LLC
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization
Address:
1498 JESSE JEWELL PKWY SE
SUITE D
GAINESVILLE, GA
ZIP 30501
Phone: (678) 450-4757
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LAKESIDE OB/GYN AND PELVIC SURGERY, LLC is an obstetrics gynecology in Gainesville, GA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. LAKESIDE OB/GYN AND PELVIC SURGERY, LLC NPI is 1720225410. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1498 JESSE JEWELL PKWY SE
SUITE D
GAINESVILLE, GA
ZIP 30501-852
Phone: (678) 450-4757
Fax: (678) 450-4758

The provider's authorized official is Rebecca Lynn Massey .
The authorized official title is Practice Administrator and has the following contact phone number (678) 450-4757.

The enumeration date for this NPI number is 1/16/2009 and was last updated on 1/16/2009.


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
1207V00000XObstetrics & GynecologyYes

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

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