NPI age
19 years
Enumerated 2006-08-11
Across 1389 active surgery providers in Georgia.
8 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000948109C | |
| 05 (GA) | 000948109D | |
| 05 (GA) | 000948109H | |
| 01 (GA) | 348302 | WELLCARE |
| 01 (GA) | 52895966 | BCBS |
| 01 (GA) | 582117020056 | TRICARE CERTIFIED |
| 01 (GA) | P01342975 | PALMETTO GBA RAILROAD MEDICARE |
| 05 (GA) | 0009481091 | |
| 05 (GA) | 000948109E | |
| 01 (GA) | 12483797 | MULTIPLAN |
| 05 (GA) | 000948109J | |
| 01 (GA) | 7573710 | CIGNA |
| 05 (GA) | 000948109M | |
| 01 (GA) | 01344195 | AMERIGROUP |
| 01 (GA) | 110029C003330 | TRAILBLAZER HEALTH ENTERPRISES |
| 01 (GA) | 1114938172 | TRICARE CERTIFIED |
| 05 (GA) | 000948109F | |
| 05 (GA) | 000948109N | |
| 01 (GA) | 7651335 | CARE IMPROVEMENT PLUS |
| 05 (GA) | 000948109K | |
| 05 (GA) | 000948109L | |
| 01 (GA) | 582117020002 | TRICARE CERTIFIED |
| 05 (GA) | 000948109O |
Part of a multi-provider practice. 10 other active providers share this practice address in NPPES.
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