NPIMap

Organization Active NPI

George Isshak,LLC

  • Vascular Surgery Physician
  • Conyers, GA
National Provider Identifier
1902079544
Registry record updated Apr 3, 2008
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Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
023369 Issued in GA
Legal business name
GEORGE ISSHAK,LLC
Practice address
1215 Vineyard Dr SE
Conyers, GA 30013-2467
Phone
(770) 653-9033
NPI assigned
Apr 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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

Authorized official

Name
Dr. George Isshak, M.D.
Title
Chief Operating Manager
Phone
(770) 653-9033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X 023369 GA Primary

Addresses

Primary practice location

1215 Vineyard Dr SE
Conyers, GA 30013-2467

Mailing address

1215 Vineyard Dr SE
Conyers, GA 30013-2467
Phone (770) 653-9033

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207180800000",
    "number": "1902079544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 VINEYARD DR SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132467",
            "telephone_number": "770-653-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 VINEYARD DR SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132467",
            "telephone_number": "770-653-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE ISSHAK,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-03",
        "last_updated": "2008-04-03",
        "status": "A",
        "authorized_official_last_name": "ISSHAK",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CHIEF OPERATING MANAGER",
        "authorized_official_telephone_number": "770-653-9033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "023369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.