| Gastroenterology Atlanta, Llc | |
|
2006 Macy Dr Roswell GA 30076-6346 | |
| (404) 257-0000 | |
| Not Available |
| Full Name | Gastroenterology Atlanta, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2006 Macy Dr, Roswell, Georgia |
| Authorized Official Name and Position | William D Lyday (OWNER) |
| Authorized Official Contact | 7704006041 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology Atlanta, Llc 3025 Breckinridge Blvd Duluth GA 30096-4979 Ph: (678) 226-0082 | Gastroenterology Atlanta, Llc 2006 Macy Dr Roswell GA 30076-6346 Ph: (404) 257-0000 |
| NPI Number | 1891737532 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 04/10/2023 |
| Medicare PECOS PAC ID | 2264429489 |
|---|---|
| Medicare Enrollment ID | O20130110000304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891737532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 008698 (Georgia) | Primary |
| Provider Name | William Davie Lyday |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1134103195 PECOS PAC ID: 7911042262 Enrollment ID: I20101124000153 |
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