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SOUTHERN CRESCENT BREAST SPECIALISTSPC NPI 1922173723


NPI Information

NPI: 1922173723
Provider Name: SOUTHERN CRESCENT BREAST SPECIALISTS,PC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
7823 SPIVEY STATION BLVD
SUITE 200
LAKE SPIVEY, GA
ZIP 30236
Phone: (770) 507-5055
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SOUTHERN CRESCENT BREAST SPECIALISTS,PC is a specialist in Lake Spivey, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SOUTHERN CRESCENT BREAST SPECIALISTS,PC NPI is 1922173723. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7823 SPIVEY STATION BLVD
SUITE 200
LAKE SPIVEY, GA
ZIP 30236-886
Phone: (770) 507-5055
Fax: (770) 507-5880

The provider's authorized official is Wendy Pearson .
The authorized official title is Practice Administrator and has the following contact phone number (770) 507-5055.

The enumeration date for this NPI number is 11/21/2006 and was last updated on 8/8/2008.


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
1174400000XSpecialistYes

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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