OrganizationActive
Southern Endoscopy Suite, LLC
NPI 1215986609 · Endoscopy Clinic/Center · Lawrenceville, GA
Provider details
- NPI number
- 1215986609
- Entity type
- Organization
- Primary specialty
- Endoscopy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Mark Kukler, Owner(678) 985-2000
Specialties & taxonomies
Ambulatory Health Care Facilities
- Ambulatory Surgical Clinic/Center261QA1903X
Ambulatory Health Care Facilities
Practice location
763 Old Norcross Rd
Lawrenceville, GA 30045-4317
Phone: (678) 985-2000
Fax: (678) 985-1999
Approximate (ZIP-level) locationGet directions
Mailing address
763 Old Norcross Rd
Lawrenceville, GA 30045-4317
Registry dates
- Enumerated
- 2006-05-10
- Last updated
- 2017-11-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.