Eastside General Surgery LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

EASTSIDE GENERAL SURGERY LLC

Practice address

1600 Medical Way
Suite 220
Snellville, GA 30078-2166

Phone

(770) 972-7999

Fax

(770) 972-9528

NPI assigned

Dec 21, 2006

Organization subpart

No

Name

Nancy Lucas

Title

Office Manager

Phone

(770) 972-7999

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

• Ruben Diaz, MD

  • Physical Medicine & Rehabilitation Physician
  • Savannah, GA
  • NPI 1194751024
  NPD (past)
• Alicia Duncan Jefferies, PA-C

  • Physician Assistant
  • Atlanta, GA
  • NPI 1861820102
  NPD (past)
• Nedra Helene Joyner, M.D.

  • Otolaryngology Physician
  • Bowie, MD
  • NPI 1891777678
  NPD (past)

Locations

• Eastside Surgical Associates Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 4, 2013.

{
    "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"
        }
    ]
}

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• Eastside Behavioral Health Associates LLC
• Eastside Endocrine, PC
• Eastside Medical Center, LLC
• Eastside Medical Center, LLC
• Eastside Medical Center, LLC
• Eastside Medical Center, LLC
• Eastside Medical Center, LLC

• All providers in Snellville, GA
• Specialist in Georgia

• 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.