Unknown Individual – Anesthesiology Physician, NPI 1336196286

Unknown Individual is a healthcare provider. based in Jonesboro, Georgia. specializing in Anesthesiology Physician. They hold a License No. 031256 (GA). The NPI Number for Unknown Individual is 1336196286

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1336196286
Phone
(770) 968-9978
Address
PO BOX 278
Deactivation Date
4 August 2021

Doctor Profile

Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7709689978
Graduation Year
1985 (41 years ago)
PAC ID
7416994645
Group Practice PAC ID
5799774642
Professional Enrollment ID
I20091019000132
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • PO BOX 278

    JONESBORO, GA 302370278

    Phone: (770) 968-9978

    Fax: (770) 968-9975

    Type: Mailing

  • 6649, Lake Drive, Morrow, Clayton County, Georgia, 30260, United States

    MORROW, GA 302602354

    Phone: (770) 968-9978

    Fax: (770) 968-9975

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30237)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5799774642View full group profile
NameSpecialtyState
-GA
A N E S T H E S I O L O G YGA
-GA

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1336196286.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Jonesboro, Georgia in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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