SOUTHERN CRESCENT NEUROLOGICAL CLINIC,PC
NPI 1013052182
Psychiatry & Neurology - Neurology in Fayetteville, GA

Q: What is Southern Crescent Neurological Clinic,pc's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Active since February 20, 2007

1250 HIGHWAY 54 W, 102, FAYETTEVILLE, GA 30214(770) 719-2965(770) 719-2963 Get Directions Write a Review

NPPES record last updated: June 21, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Southern Crescent Neurological Clinic,pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN CRESCENT NEUROLOGICAL CLINIC,PC (NPI 1013052182) is a healthcare organization registered as a neurology in Fayetteville, Georgia and active in the NPI registry since February 2007. The organization lists Kenneth Jay Lazarus, Ceo, as its authorized official.

NPPES Registry Identity

NPI1013052182

Entity TypeOrganization

Primary Taxonomy2084N0400X

Legal Business NameSOUTHERN CRESCENT NEUROLOGICAL CLINIC,PC

Location Address1250 HIGHWAY 54 W, 102Fayetteville, GA 30214-4545

Mailing Address1250 Highway 54 W, 102Fayetteville, GA 30214-4545 · (770) 719-2965 · Fax (770) 719-2963

Phone(770) 719-2965

Fax(770) 719-2963

Organization SubpartNo

Authorized OfficialKenneth Jay LazarusCeo · (770) 719-2965

Enumeration DateFebruary 20, 2007

Last NPPES UpdateJune 21, 2018

✔ NPI 1013052182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians

Taxonomy Code2084N0400X

License✔ Licensed in GA · 031058

Definition

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.

1250 HIGHWAY 54 W, Fayetteville, GA 30214

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Other Identifiers 2

OtherGRP2807GA · Medicare Facility Id

Medicaid000406795DGA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. HARVELYN DUNCAN SMITH P.T.

Physical Therapist

1250 HIGHWAY 54 W
FAYETTEVILLE, GA 30214

Fayette County (770) 719-7290

MS. CLAVEL A GITTENS FNP-BC

Nurse Practitioner (Family)

1250 HIGHWAY 54 W, SUITE 102
FAYETTEVILLE, GA 30214

Fayette County (678) 817-1117

DR. KENNETH J LAZARUS MD,PHD

Psychiatry & Neurology (Neurology)

1250 HIGHWAY 54 W, STE. 102
FAYETTEVILLE, GA 30214

Fayette County (770) 719-2965

MS. DEBBIE S. DAVIS MSN

Nurse Practitioner (Family)

1250 HIGHWAY 54 W, SUITE #102
FAYETTEVILLE, GA 30214

Fayette County (678) 817-1117

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Crescent Neurological Clinic,pc's NPI number?

The NPI number for Southern Crescent Neurological Clinic,pc is 1013052182. It was assigned to this organization in the NPPES registry on February 20, 2007.

Where is Southern Crescent Neurological Clinic,pc located?

Southern Crescent Neurological Clinic,pc is located at 1250 Highway 54 W 102, Fayetteville, GA 30214. The listed phone number is (770) 719-2965.

What is Southern Crescent Neurological Clinic,pc's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

When was this NPI record last updated?

The NPPES record for Southern Crescent Neurological Clinic,pc was last updated on June 21, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.