Unknown Individual – Specialist, NPI 1124103270
Specialist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
449, Pleasant Hill Road, Luxomni, Lilburn, Gwinnett County, Georgia, 30047, United States
LILBURN, GA 300472770
Phone: (770) 935-1515
Fax: (770) 935-1040
Type: Location
Lilburn, Gwinnett County, Georgia, 30047, United States
LILBURN, GA 300480369
Phone: (770) 935-1515
Fax: (770) 935-1040
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30047)
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