Gwinnett Physician Group, LLC

NPI #1578574661 in Lawrenceville, Georgia

Provider Information

NPI Number
1578574661
Entity Type
Organization
Organization Name
Gwinnett Physician Group, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
NORTHSIDE HOSPITAL, INC
Primary Specialty
Internal Medicine
Enumeration Date
Aug 11, 2006
Last Updated
Jun 2, 2025

Practice Location

Address
1000 MEDICAL CENTER BLVD
Address 2
MOB 100 SUITE 210
State
Georgia
ZIP Code
30046-7694
Phone
(855) 709-4535

Authorized Official

Name
MR. JORGE HERNANDEZ
Title
EXECUTIVE DIRECTOR
Phone
(404) 851-6378

Specialties & Taxonomy Codes

Specialty
Family Medicine
Obstetrics & Gynecology
Internal Medicine

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