NPIMap

Organization Active NPI

Eastside General Surgery LLC

Doing business as Eastside Surgical Associates

  • Specialist
  • Snellville, GA
National Provider Identifier
1992869192
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
EASTSIDE GENERAL SURGERY LLC
Doing business as
Eastside Surgical Associates
Practice address
1600 Medical Way
Suite 220
Snellville, GA 30078-2166
Phone
(770) 972-7999
Fax
(770) 972-9528
NPI assigned
Dec 21, 2006
Last updated
Sep 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Authorized official

Name
Nancy Lucas
Title
Office Manager
Phone
(770) 972-7999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1600 Medical Way
Suite 220
Snellville, GA 30078-2166

Mailing address

1600 Medical Way
Suite 220
Snellville, GA 30078-2166
Phone (770) 972-7999

Other names 1

  • Eastside Surgical Associates Doing business as

National Provider Directory

National Provider Directory

Locations

3805 Pleasant Hill Rd
Duluth, GA 30096
Phone (678) 312-7000

1700 Tree Ln
Ste 320
Snellville, GA 30078
Phone (770) 985-6233

1700 Tree Ln
Ste 390
Snellville, GA 30078
Phone (770) 972-0619

1700 Tree Ln
Ste 410
Snellville, GA 30078

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1992869192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL WAY",
            "address_2": "SUITE 220",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782166",
            "telephone_number": "770-972-7999",
            "fax_number": "770-972-9528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL WAY",
            "address_2": "SUITE 220",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782166",
            "telephone_number": "770-972-7999",
            "fax_number": "770-972-9528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE GENERAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-972-7999"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastside Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; 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.