Organization
NORTHEAST ENDOSCOPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM GORDON TANNER JR. M.D. (DIRECTOR)
(678) 879-0999
Entity
Organization
Contact information
Practice address
721 WELLNESS WAY, STE 110, LAWRENCEVILLE, GA 30046-3304
(678) 879-0999
(678) 578-6873
Mailing address
721 WELLNESS WAY, STE 110, LAWRENCEVILLE, GA 30046-3304
(678) 879-0999
(678) 879-0109
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
067329
GA
Other
Enumeration date
03/09/2006
Last updated
08/07/2014
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