Jacek Lyszkowicz MD PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

047113 Issued in GA

Legal business name

JACEK LYSZKOWICZ MD PC

Practice address

1366 Wellbrook Cir NE
Suite B
Conyers, GA 30012-3872

Phone

(770) 922-9622

Fax

(770) 922-9620

NPI assigned

May 20, 2006

Last updated

Apr 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jacek Eustachy Lyszkowicz, MD

Title

Owner

Phone

(770) 922-9622

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1598719007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1366 WELLBROOK CIR NE",
            "address_2": "SUITE B",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123872",
            "telephone_number": "770-922-9622",
            "fax_number": "770-922-9620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 WELLBROOK CIR NE",
            "address_2": "SUITE B",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123872",
            "telephone_number": "770-922-9622",
            "fax_number": "770-922-9620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACEK LYSZKOWICZ MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "LYSZKOWICZ",
        "authorized_official_first_name": "JACEK",
        "authorized_official_middle_name": "EUSTACHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-922-9622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "047113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Delon Irby, DMD
• John Tucker Irwin
• Karen Stefani Isaacson, D.C.
• Adekemi Abosede Ishola, MD, MBA
• George Isshak, M.D.
• Marvalene Roslynn Jack
• Neda Marie Jackson Lawson, APRN, FNP-C
• Laverne L. Jackson, RN,ICADC
• Litiki Jackson
• Robert Jackson

• Family Medicine Physician in Conyers, GA
• Providers in Conyers, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.