Unknown Individual – Family Medicine Physician, NPI 1043376841

Unknown Individual is a healthcare provider. based in Lyons, Georgia. specializing in Family Medicine Physician. They hold a License No. 034904 (GA). The NPI Number for Unknown Individual is 1043376841

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1043376841
Phone
(912) 526-6567
Address
127 MOODY CIR
Deactivation Date
22 September 2021
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

Provider Addresses for Unknown Individual

  • 127 MOODY CIR

    LYONS, GA 304361428

    Phone: (912) 526-6567

    Fax: (912) 526-0471

    Type: Mailing

  • 113 MOODY CIR

    LYONS, GA 304361428

    Phone: (912) 526-6567

    Fax: (912) 526-0471

    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.

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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 30436)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1043376841?
NPI 1043376841 belongs to Unknown Individual; compare other details if you need extra assurance.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Lyons?
Unknown Individual currently maps to Lyons, Georgia in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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