SOUTHERN GASTROENTEROLOGY ASSOCIATES, LLC (NPI# 1205886504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205886504 |
| Entity Type | Organization |
| Organization Name | SOUTHERN GASTROENTEROLOGY ASSOCIATES, LLC |
| Practice Address |
763 Old Norcross Rd Lawrenceville GA 30045-4317 |
| Practice Telephone | 6789852000 |
| Practice Fax Number | 6789851999 |
| Mailing Telephone | 6789852000 |
| Mailing Fax Number | 6789851999 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2012-05-30 |
| Authorized Official Name | MARK B. KUKLER (OWNER) |
| Authorized Official Telephone | 6789852000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| Street Address |
763 OLD NORCROSS RD |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30045-4317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952350332 | Tanya M. Rutledge | Internal Medicine | 763 Old Norcross Rd, Lawrenceville, GA 30046-4317 | 2006-05-10 |
| 1568897668 | Stephen Beasley | Internal Medicine | 763 Old Norcross Rd, Lawrenceville, GA 30046-4317 | 2013-09-08 |
| 1053750646 | Sg Anesthesia LLC | Nurse Anesthetist, Certified Registered | 763 Old Norcross Rd, Lawrenceville, GA 30046-4317 | 2013-06-18 |
| 1013264654 | Ahp of Gwinnett, LLC | Nurse Anesthetist, Certified Registered | 763 Old Norcross Rd, Lawrenceville, GA 30046-4317 | 2012-08-14 |
| 1952588394 | Amil P Patel | Internal Medicine | 763 Old Norcross Rd, Lawrenceville, GA 30046-4317 | 2008-01-29 |
| 1295785814 | Marcelle M. Owens | Internal Medicine | 763 Old Norcross Rd, Lawrenceville, GA 30046-4317 | 2006-05-12 |
| 1093765265 | Mark B. Kukler | Internal Medicine | 763 Old Norcross Rd, Lawrenceville, GA 30046-4317 | 2006-05-11 |
| 1548210859 | Arvind A. Kulkarni | Internal Medicine | 763 Old Norcross Rd, Lawrenceville, GA 30046-4317 | 2006-05-10 |
| 1215986609 | Southern Endoscopy Suite, LLC | Clinic/Center | 763 Old Norcross Rd, Lawrenceville, GA 30045-4317 | 2006-05-10 |
| 1275583437 | Scott W. Schorr | Internal Medicine | 763 Old Norcross Rd, Lawrenceville, GA 30046-4317 | 2006-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285104315 | Shalanda Monique Booker | Counselor | 2940 Emerald Springs Drive, Lawrenceville, GA 30045 | 2018-12-02 |
| 1669957320 | Chantelle S Fuller | Behavioral Analyst | 805 Donington Cir, Lawrenceville, GA 30045 | 2018-09-28 |
| 1356836035 | Gad Health Care LLC | Home Health | 1140 Great Oaks Dr, Lawrenceville, GA 30045 | 2018-06-26 |
| 1346668662 | Eca Optical, LLC | Eyewear Supplier (Equipment, not the service) | 601-a Professional Drive, Ste 170, Lawrenceville, GA 30045 | 2014-04-03 |
| 1598102733 | Selena Fuller | Nurse Practitioner | 181 South Clayton Street, Lawrenceville, GA 30045 | 2013-05-29 |
| 1942555982 | Vida Michele James-bryant | Community Health Worker | 1309 Avington Glen Dr, Lawrenceville, GA 30045 | 2012-07-16 |
| 1770840639 | Rebecca Vinson D'angelo | Occupational Therapist | 1518 Great Shoals Cir, Lawrenceville, GA 30045 | 2012-04-17 |
| 1427346774 | Amanda Michelel Woods | Psychologist | 285 South Perry Street, Lawrenceville, GA 30045 | 2011-07-20 |
| 1790070563 | M & G Pharmacy Inc | Pharmacy | 100 Hurricane Shoals Rd Suite F, Lawrenceville, GA 30045 | 2011-06-09 |
| 1306146154 | Thanh Dau | Optometrist | 1250 Scenic Highway, Ste 1268, Lawrenceville, GA 30045 | 2010-10-27 |
| Find all providers in zip 30045 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699872218 | Michael Gersten | Internal Medicine | 3 Vanderveer Dr, Lawrenceville, NJ 08648-3113 | 2006-09-17 |
| 1952350332 | Tanya M. Rutledge | Internal Medicine | 763 Old Norcross Rd, Lawrenceville, GA 30046-4317 | 2006-05-10 |
| 1285624148 | Srinivasa Rao Ayinala | Internal Medicine | 301 Philip Blvd Ste A, Lawrenceville, GA 30046 | 2005-10-24 |
| 1427042514 | Zack Zeke Martin | Internal Medicine | 721 Wellness Way, Ste 100, Lawrenceville, GA 30046 | 2005-09-06 |
| 1205245982 | James B Canavan | Internal Medicine | 3401 Princeton Pike, Lawrenceville, NJ 08648-1205 | 2014-08-07 |
| 1972755650 | North Georgia Digestive Disease Consultants, LLC | Internal Medicine | 475 Philip Blvd, 304, Lawrenceville, GA 30046-8737 | 2008-10-14 |
| 1629231048 | Mehul Parikh | Internal Medicine | 721 Wellness Way, Suite 100, Lawrenceville, GA 30046-3304 | 2008-07-07 |
| 1033370762 | Bennett H. Bruckner,m.d., P.C. | Internal Medicine | 575 Professional Dr, Suite 290, Lawrenceville, GA 30045-3333 | 2008-06-25 |
| 1437319993 | Donald Minh Pham | Internal Medicine | 301 Philip Blvd Ste A, Lawrenceville, GA 30046 | 2008-06-09 |
| 1609033315 | Susan G Coe | Internal Medicine | 301 Philip Blvd Ste A, Lawrenceville, GA 30046 | 2008-05-20 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30045 |
Please comment or provide details below to improve the information on SOUTHERN GASTROENTEROLOGY ASSOCIATES, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.