Organization
NORTH GEORGIA SURGICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM H LUMPKIN MD (SOLE MBR)
(706) 278-0351
Entity
Organization
Contact information
Practice address
1504 N THORNTON AVE, SUITE 101B, DALTON, GA 30720-8394
(706) 278-0351
Mailing address
1801 HUNTINGTON WOODS WAY, DALTON, GA 30720-3838
(706) 248-0351
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
020574
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000180353C
—
GA
01
—
01281439
AMERIGROUP
GA
01
—
N0503836
WELLCARE
GA
Enumeration date
01/20/2012
Last updated
03/07/2023
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