Individual
DR. GEORGE T ASTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
953 MAPLE ST, CARROLLTON, GA 30117-3657
(770) 836-9062
(770) 836-9076
Mailing address
953 MAPLE ST, CARROLLTON, GA 30117-3657
(770) 836-9062
(770) 836-9076
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
00011651
AL
207Q00000X
Family Medicine Physician
Primary
26439
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00011651
STATE LICENSE
AL
01
—
26439
STATE LICENSE
GA
Enumeration date
08/15/2006
Last updated
07/08/2007
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