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Southern Crescent Neurological Clinic,PC

Neurology Physician in Fayetteville, GA · enumerated 2007 · authorized official Kenneth Lazarus, Ceo.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1013052182

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Registry record

Entity type Organization (Type 2)
Legal business name Southern Crescent Neurological Clinic,PC
Practice address 1250 Highway 54 W, 102, Fayetteville, GA, 30214
Phone (770) 719-2965
Fax (770) 719-2963
Enumeration date Feb 20, 2007
Last updated in NPPES Jun 21, 2018

Taxonomy & classification

2084N0400X Neurology Physician Allopathic & Osteopathic Physicians · License 031058 (GA) Primary

Authorized official

Name Kenneth Lazarus
Title Ceo
Phone (770) 719-2965

Other identifiers

Identifier Type State Issuer
000406795D Medicaid GA -
GRP2807 Other GA MEDICARE FACILITY ID

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Southern Crescent Neurological Clinic,PC located?
The practice location on file with NPPES is in Fayetteville, GA.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2018-06-21. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2018-06-21.