Healthcare Provider Details

I. General information

NPI: 1023772688
Provider Name (Legal Business Name): GWINNETT SURGICAL ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2021
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 PROFESSIONAL DR STE 300
LAWRENCEVILLE GA
30046-3371
US

IV. Provider business mailing address

631 PROFESSIONAL DR STE 300
LAWRENCEVILLE GA
30046-3371
US

V. Phone/Fax

Practice location:
  • Phone: 770-962-9977
  • Fax:
Mailing address:
  • Phone: 770-962-9977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEAN-CLAUDE SCHWARTZ
Title or Position: PARTNER
Credential: MD, PHD
Phone: 770-962-9977