NPI age
20 years
Enumerated 2005-08-23
Across 1389 active surgery providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | P00603468 | RAILROAD MEDICARE - PTAN |
| 05 (GA) | 000199328C | |
| 01 (GA) | 11D0265294 | CLIA ID - 1309 OCILLA RD - STE A |
| 01 (GA) | DH1281 | RAILROAD MEDICARE - GROUP # |
| 01 (GA) | 11D1105865 | CLIA ID - 17 JOHNSON ST |
| 01 (GA) | 341237 | WELLCARE |
| 01 (GA) | 023646 | PHYSICIAN LICENSE # |
| 05 (GA) | 000199328B |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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