Organization · Type 2 NPI

Northeast Georgia Specialty Group LLC

Specialist · Gainesville, GA

NPI number 1447443387 Active

Practice location

601 S Enota Dr NE, Suite Q
Gainesville, GA 30501-2400

Fax (770) 533-8409

Specialties and licenses

Taxonomy	Code	License
Specialist Primary	174400000X	None listed
Critical Care Medicine (Anesthesiology) Physician	207LC0200X	None listed
Sports Medicine (Family Medicine) Physician	207QS0010X	None listed
Cardiovascular Disease Physician	207RC0000X	None listed
Neurological Surgery Physician	207T00000X	None listed
Neurology Physician	2084N0400X	None listed
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	208G00000X	None listed
Physician Assistant	363A00000X	None listed

Specialist: 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.

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NPI record

NPI: 1447443387
Entity type: Organization (Type 2)
Issued: Aug 23, 2007
Last updated: Apr 28, 2008
Status: Active
Subpart: Yes of Northeast Georgia Primary Care, Inc.

Other names

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Neurology Physician Group and Advantage Sports Medicine · doing business as

Authorized official

Mark Klein
Executive Director
(770) 533-8406

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1447443387

Northeast Georgia Specialty Group LLC's National Provider Identifier is 1447443387, issued on Aug 23, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Gainesville, GA. The record was last updated on Apr 28, 2008.