Putnam Neurology Group, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME108923 Issued in FL

Legal business name

PUTNAM NEUROLOGY GROUP, INC.

Practice address

800 Zeagler Dr
Suite #230
Palatka, FL 32177-3883

Phone

(386) 385-3043

Fax

(386) 385-3187

NPI assigned

Dec 4, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Fawzi Yousef Elsagga, M.D.NPI 1336346881

Title

President

Phone

(386) 385-3043

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fawzi Y. Elsagga, M.D.

  • Neurology Physician
  • Palatka, FL
  • NPI 1336346881
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1417651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1346647435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ZEAGLER DR",
            "address_2": "SUITE #230",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773883",
            "telephone_number": "386-385-3043",
            "fax_number": "386-385-3187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ZEAGLER DR",
            "address_2": "SUITE #230",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773883",
            "telephone_number": "386-385-3043",
            "fax_number": "386-385-3187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUTNAM NEUROLOGY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-04",
        "last_updated": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "ELSAGGA",
        "authorized_official_first_name": "FAWZI",
        "authorized_official_middle_name": "YOUSEF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-385-3043",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME108923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Putnam E N T PA
• Putnam Emergency Group LLC
• Putnam Family Care, Inc.
• Putnam Heart Center PA
• Putnam Imaging Center, LLC
• Putnam Obstetrics and Gynecology PA
• Putnam Physician Practices (Putnam Neurology Associates)
• Putnam Physician Practices LLC (Putnam Surgical Associates)
• Putnam Physician Practices LLC (Orthopedics and Sports Specialists of Putnam)
• Putnam Physician Practices LLC (Putnam Cardiovascular Associates)

• Specialist in Palatka, FL
• Providers in Palatka, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.