Southern Crescent Neurological Clinic,pc

Neurology Clinic

1250 Highway 54 W, 102, Fayetteville
    Georgia, 30214-4545

 770-719-2965    770-719-2963 Maps & Directions
Southern Crescent Neurological Clinic,pc is a Neurology Clinic in Fayetteville, Georgia. It is located at 1250 Highway 54 W, 102, Fayetteville, GA and its contact number is 770-719-2965. The authorized person for Southern Crescent Neurological Clinic,pc is Dr. Kenneth Jay Lazarus who is Ceo of the clinic and his/her contact number is 770-719-2965. The primary license number for Southern Crescent Neurological Clinic,pc is 031058 (Neurology) in Georgia.
Southern Crescent Neurological Clinic,pc Clinic specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Complete Clinic Profile:
Southern Crescent Neurological Clinic,pc Clinic speciality, address, contact phone number and fax are as below. Patients can call on the below given phone number for appointments.
Name: Southern Crescent Neurological Clinic,pc
Specialization: Neurology
Clinic Address:1250 Highway 54 W, 102, Fayetteville,
Georgia, 30214-4545
Phone:770-719-2965
Fax:770-719-2963
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name: Dr. Kenneth Jay Lazarus
Position: Ceo
Contact Number: 770-719-2965
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Southern Crescent Neurological Clinic,pc clinic are as mentioned below.
NPI Number: 1013052182
NPI Enumeration Date: 20 Feb, 2007
NPI Last Update On: 21 Jun, 2018
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Southern Crescent Neurological Clinic,pc are as mentioned below.
SpecializationLicense NumberStateStatus
Neurology 031058GeorgiaPrimary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
IdentifierTypeStateIssuer
000406795DMedicaidGeorgia
GRP2807OtherGeorgiaMedicare Facility Id
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address: Southern Crescent Neurological Clinic,pc
1250 Highway 54 W, 102
Fayetteville, Georgia
Zip: 30214-4545
Phone Number: 770-719-2965
Fax Number: 770-719-2963
Patients can reach Southern Crescent Neurological Clinic,pc at 1250 Highway 54 W, 102, Fayetteville, Georgia or can call to book an appointment on 770-719-2965.
*Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.

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