LAKESIDE NEUROLOGY, PC (NPI# 1386172229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386172229 |
| Entity Type | Organization |
| Organization Name | LAKESIDE NEUROLOGY, PC |
| Practice Address |
1100 Northside Forsyth Dr Ste 440 Cumming GA 30041-6015 |
| Practice Telephone | 6787724422 |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2018-05-07 |
| Authorized Official Name | DR. FRANK PUHALOVICH (PRESIDENT) |
| Authorized Official Telephone | 6787724422 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Street Address |
1100 NORTHSIDE FORSYTH DR STE 440 |
| City | CUMMING |
| State | GA |
| Zip Code | 30041-6015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912990391 | Peter R Futrell | Psychiatry & Neurology | 1100 Northside Forsyth Dr Ste 440, Cumming, GA 30041-6015 | 2005-08-31 |
| 1548253941 | Frank Puhalovich | Psychiatry & Neurology | 1100 Northside Forsyth Dr Ste 440, Cumming, GA 30041-6015 | 2005-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962036905 | Annie Kyungjin Han | Nurse Practitioner | 1505 Northside Forsyth Drive, Suite 2500, Cumming, GA 30041 | 2020-02-28 |
| 1295388197 | Pamela Edler | Pharmacist | 1200 Northside Forsyth Drive, Pharmacy Department, Cumming, GA 30041 | 2019-07-19 |
| 1720557127 | Dr. Tiffany Lamonde LLC | Physical Therapist | 1445 Haw Creek Circle, Suite 503, Cumming, GA 30041 | 2018-11-15 |
| 1487140893 | Bhbd LLC | Chiropractor | 425 Peachtree Parkway, Suite 315, Cumming, GA 30041 | 2018-07-09 |
| 1891219861 | Anna Gawrys | Pharmacist | 1525 Marketplace Blvd, Cumming, GA 30041 | 2017-08-01 |
| 1679029219 | Square One Dental LLC | Clinic/Center | 3510 Rowe Lane, Cumming, GA 30041 | 2016-09-01 |
| 1720441454 | Pavilion Psychological Services LLC | Psychologist | 1445 Haw Creek Corners Circle East, Suite 501, Cumming, GA 30041 | 2016-03-31 |
| 1346606506 | American Health Imaging of Ga, LLC | Clinic/Center | 1050 Haw Creek Pkwy, Suite 100, Cumming, GA 30041 | 2016-01-04 |
| 1013311307 | Stephen Hartle | Physician Assistant | 2576 Peachtree Pkwy, Suite 100, Cumming, GA 30041 | 2014-10-15 |
| 1063828408 | Stephanie Evans Wellborn | Physician Assistant | 1800 Northside Forsyth Dr Ste 450, Cumming, GA 30041 | 2014-07-07 |
| Find all providers in zip 30041 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist 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. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902885494 | Reginald Vinson Hall | Psychiatry & Neurology | 1400 Northside Forsyth Dr Ste 250, Cumming, GA 30041-7701 | 2006-01-12 |
| 1407849888 | Bernard R Drexinger | Psychiatry & Neurology | 1100 Northside Forsyth Dr Ste 210, Cumming, GA 30041-6016 | 2005-08-31 |
| 1912990391 | Peter R Futrell | Psychiatry & Neurology | 1100 Northside Forsyth Dr Ste 440, Cumming, GA 30041-6015 | 2005-08-31 |
| 1205843588 | Scott D Cooper | Psychiatry & Neurology | 1400 Northside Forsyth Dr Ste 250, Cumming, GA 30041-7701 | 2006-08-01 |
| 1720002694 | Janel S Schneider | Psychiatry & Neurology | 1200 Northside Forsyth Dr, Cumming, GA 30041-7659 | 2006-07-26 |
| 1548253941 | Frank Puhalovich | Psychiatry & Neurology | 1100 Northside Forsyth Dr Ste 440, Cumming, GA 30041-6015 | 2005-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013544899 | Southern Neurology, Physical Medicine & Rehabilitation, LLC | Psychiatry & Neurology | 4913 Lanes Pond Rd, Valdosta, GA 31601-1537 | 2020-03-24 |
| 1912474537 | Atlanta Neuromonitoring, LLC | Psychiatry & Neurology | 922 Highway 81 East # 242, Mcdonough, GA 30252 | 2018-11-01 |
| 1366925497 | David Wayne Richardson | Psychiatry & Neurology | 400 Rock Springs Road Ne, Atlanta, GA 30324 | 2018-09-14 |
| 1407349103 | Ahmed Babiker | Psychiatry & Neurology | 1130 15th St, Augusta, GA 30912-0004 | 2018-06-07 |
| 1811342561 | The Migraine and Spine Clinic of Valdosta LLC | Psychiatry & Neurology | 3315 N Valdosta Rd, Suite A, Valdosta, GA 31602-1107 | 2016-05-02 |
| 1164882635 | Lafayette Neurology, PC | Psychiatry & Neurology | 1075 Lafayette Parkway, Suite 210, Lagrange, GA 30241-3584 | 2016-02-26 |
| 1144601048 | Catherine Lockhart | Psychiatry & Neurology | 2470 Daniels Bridge Rd Ste 261, Athens, GA 30606-6188 | 2015-06-16 |
| 1609266634 | Bruce Gillett | Psychiatry & Neurology | 948 Greymont Cir Nw, Marietta, GA 30064-1328 | 2015-01-29 |
| 1245620244 | Darla R Totten Md | Psychiatry & Neurology | 3780 Northside Dr, 197, Macon, GA 31210-2431 | 2015-01-28 |
| 1033516356 | Neuro Proread Solutions | Psychiatry & Neurology | 2378 Riderwood Court, Marietta, GA 30062-4689 | 2014-12-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.