Individual
DR. BRIAN ERIC GAUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
919 S BROAD ST, THOMASVILLE, GA 31792-6114
(229) 584-5400
Mailing address
920 CAIRO RD, THOMASVILLE, GA 31792-4255
(229) 228-2970
(229) 551-8730
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
047594
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00837845C
—
GA
01
—
52782026
BLUE CROSS BLUE SHIELD
GA
01
—
830007293
RAILROAD MEDICARE
GA
Enumeration date
09/17/2005
Last updated
09/17/2020
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