L Mark Gustafson in Carrollton - Otolaryngology
L Mark Gustafson - NPI 1073555629
L Mark Gustafson is a Otolaryngology in Carrollton, Georgia. L Mark Gustafson practices all healthcare services and medical treatments related to Otolaryngology. The NPI Number for L Mark Gustafson is 1073555629. The last update date is 2022-07-18.
L Mark Gustafson's current location address is 150 Clinic Ave, Carrollton, Georgia. You can contact this provider via phone number 7708321488. The mailing address for L Mark Gustafson is 150 Clinic Ave, Carrollton, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | L Mark Gustafson |
|---|---|
| Address | 150 Clinic Ave, Carrollton, Georgia |
| Phone Number | 7708321488 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1073555629 |
|---|---|
| Provider Enumeration Date | 2006-06-11 |
| Last Updated Date | 2022-07-18 |
Provider Mailing Address Detail
| Address | 150 Clinic Ave |
|---|---|
| City | Carrollton |
| State | Georgia (GA) |
| Post Code | 301174401 |
| Phone Number | 7708321488 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Otolaryngology |
|---|---|
| Taxonomy | 207Y00000X |
| Licence No | 49795 |
|
Definition: An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head an |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 841043 | GA | BLUE CROSS CLUE SHIELD | |
| 00906463C | GA | -- | |
| 00906463B | GA | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to L Mark Gustafson?
The L Mark Gustafson has been issued the NPI (National Provider Identifier) 1073555629 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Where is the L Mark Gustafson located?
The L Mark Gustafson is located at 150 Clinic Ave, Carrollton, GA 301174401.
What is L Mark Gustafson's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for L Mark Gustafson is Otolaryngology, and the taxonomy classification code that categorizes this area of expertise is 207Y00000X.
On what date did L Mark Gustafson receive its 1073555629 assignment from the Centers for Medicare & Medicaid Services?
The L Mark Gustafson was assigned its 1073555629 on 2006-06-11, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the L Mark Gustafson's information last updated?
The L Mark Gustafson's information was last updated on 2022-07-18.