Active NPI
Stephen Gerard Quill, MD
- Surgery Physician
- Lawrenceville, GA
National Provider Identifier
1265439020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 035321
- Practice address
- 771 Old Norcross Rd
Suite 300
Lawrenceville, GA 30046-4386 - Phone
- (770) 338-8362
- Fax
- (770) 338-8364
- NPI assigned
- Jul 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 035321 | GA | Primary |
Addresses
Primary practice location
771 Old Norcross Rd
Suite 300
Lawrenceville, GA 30046-4386
Mailing address
771 Old Norcross Rd
Suite 300
Lawrenceville, GA 30046-4386
Phone (770) 338-8362
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 035321 | GA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452556800000",
"number": "1265439020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "771 OLD NORCROSS RD",
"address_2": "SUITE 300",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300464386",
"telephone_number": "770-338-8362",
"fax_number": "770-338-8364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "771 OLD NORCROSS RD",
"address_2": "SUITE 300",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300464386",
"telephone_number": "770-338-8362",
"fax_number": "770-338-8364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUILL",
"first_name": "STEPHEN",
"middle_name": "GERARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-07",
"last_updated": "2016-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "GA",
"license": "035321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.