# SOUTHERN GASTROENTEROLOGY ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205886504
- **Authorized official:** MARK B. KUKLER M.D. (OWNER)
- **Authorized official phone:** (678) 985-2000

## Contact information

- **Practice address:** 763 OLD NORCROSS RD, LAWRENCEVILLE, GA 30045-4317
- **Practice address phone:** (678) 985-2000
- **Practice address fax:** (678) 985-1999
- **Mailing address:** 763 OLD NORCROSS RD, LAWRENCEVILLE, GA 30045-4317
- **Mailing address phone:** (678) 985-2000
- **Mailing address fax:** (678) 985-1999

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/10/2006
- **Last updated:** 05/30/2012