Provider Demographics
NPI:1023772688
Name:GWINNETT SURGICAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:GWINNETT SURGICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN-CLAUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:770-962-9977
Mailing Address - Street 1:631 PROFESSIONAL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-3371
Mailing Address - Country:US
Mailing Address - Phone:770-962-9977
Mailing Address - Fax:
Practice Address - Street 1:631 PROFESSIONAL DR STE 300
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3371
Practice Address - Country:US
Practice Address - Phone:770-962-9977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty