Individual
DR. MATTHEW DEAN SOCKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 ANSLEY DR, DAHLONEGA, GA 30533-1614
(706) 867-4116
(706) 867-4120
Mailing address
PO BOX 1565, DAHLONEGA, GA 30533-0027
(706) 867-4116
(706) 867-4120
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036616
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
036616
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000539107I
—
GA
01
—
217890
BCBSGA PROVIDER ID NUMBER
GA
Enumeration date
08/10/2005
Last updated
05/20/2021
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