Unknown Individual – Surgery Physician, NPI 1548240815
Surgery Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
PO BOX 658
GAINESVILLE, GA 305030658
Phone: (770) 718-1122
Fax: (770) 535-7445
Type: Mailing
Longstreet Cancer Center, 725, Jesse Jewell Parkway Southeast, Gainesville, Hall County, Georgia, 30501, United States
SUITE 350
GAINESVILLE, GA 305013834
Phone: (770) 536-2323
Fax: (770) 536-4947
Type: Location
2200 Old Hamilton Pl
Gainesville, GA 305077892
Phone: (770) 536-2323
Fax: (770) 536-4947
Type: Location
675 White Sulphur Rd
Gainesville, GA 305018921
Phone: (770) 536-2323
Fax: (770) 536-4947
Type: Location
316 N Broad St
Winder, GA 306802150
Phone: (770) 536-2323
Fax: (770) 536-4947
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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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.
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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 30503)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GENERAL SURGERY | GA | 11042 | Removal of skin and tissue first 20 sq cm or less | 92 | 46 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | GA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA | |
| Family Practice | GA | |
| - | GA | |
| General Surgery | GA | |
| Diagnostic Radiology | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| - | GA | |
| Certified Nurse Midwife (Cnm) | GA |
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