Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. David William Conn, PA-C

Individual provider Surgical Physician Assistant · NPI 1164099958

Mr. David William Conn, PA-C is a Physician Assistant in Lawrenceville, Georgia. Qualified in 2021, 5 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
5
Licensed in
GA
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

601 Professional Dr Ste 220
Lawrenceville, GA 30046-7649
Phone: (912) 695-0342
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 10388 (GA)

Record details

NPI number1164099958
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJune 9, 2021
Last updated in NPPESMarch 16, 2022
Certification dateMarch 16, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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