Individual
GEORGINA KESTERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10579 BENT TREE VW, JOHNS CREEK, GA 30097-5988
(901) 482-0207
(828) 484-2057
Mailing address
10579 BENT TREE VW, JOHNS CREEK, GA 30097-5988
(901) 482-0207
(828) 484-2057
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
22804
MS
207L00000X
Anesthesiology Physician
27587
TN
207L00000X
Anesthesiology Physician
Primary
33167
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126012
—
MS
05
—
129644001
—
AR
05
—
208281006
—
MO
01
—
3076997
BLUECROSS BLUESHIELD
TN
05
—
3097335
—
TN
01
—
50048038
MEDICARE RAILROAD
—
01
—
97274
BLUECROSS BLUESHIELD
AR
Enumeration date
01/28/2006
Last updated
06/06/2019
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