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Individual

DR. PATRICIA DIANNE COUSSENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
259 BROAD ST, HAWKINSVILLE, GA 31036-4818
(478) 300-7107
(478) 783-3961
Mailing address
259 BROAD ST, HAWKINSVILLE, GA 31036-4818
(478) 300-7107
(478) 205-0909

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
029613
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000362546C
GA
05
00362546A
GA
01
029613
MEDICAL LICENSE NUMBER
GA
Enumeration date
09/28/2006
Last updated
08/15/2023
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