NORTHLAKE OBSTETRICS AND GYNECOLOGY, PC – NPI #1275690604
Obstetrics & Gynecology

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

NORTHLAKE OBSTETRICS AND GYNECOLOGY, PC is a provider located in NORCROSS, GA. NPPES has assigned the NPI number 1275690604 to NORTHLAKE OBSTETRICS AND GYNECOLOGY, PC on January 03, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207V00000X from the Health Care Provider Taxonomy code set, which is classified as Obstetrics & Gynecology.

The NPI profile was previously updated about 10 years ago on Jul 11, 2016. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for NORTHLAKE OBSTETRICS AND GYNECOLOGY, PC below.

NPI Profile for
NORTHLAKE OBSTETRICS AND GYNECOLOGY, PC

NPI Number
1275690604
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
NORTHLAKE OBSTETRICS AND GYNECOLOGY, PC
Primary location
3957 HOLCOMB BRIDGE RD.
SUITE 100
NORCROSS, GA 30092
Phone: (770) 939-5102 Fax: (770) 938-9323
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
GERARDO SOTOMAYOR
OWNER
Phone: (770) 939-5102
Updated
Identifiers

Identifiers for NORTHLAKE OBSTETRICS AND GYNECOLOGY, PC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERCLIA WAIVERGA11D0255917
MEDICAIDGA300026901A
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207V00000X
- Obstetrics & Gynecology (Primary)
GA

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.