Organization
GASTROENTEROLOGY OF NORTHEAST GEORGIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT W AINSWORTH M.D. (CEO)
(706) 745-8800
Entity
Organization
Contact information
Practice address
35 HOSPITAL RD, BLAIRSVILLE, GA 30512-3139
(706) 745-8800
(706) 745-8805
Mailing address
PO BOX 759, BLAIRSVILLE, GA 30514-0759
(706) 745-8800
(706) 745-8805
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005857
BLUE CROSS BLUE SHIELD
GA
01
—
122605
UNITED HEALTHCARE
GA
05
—
376554453A
—
GA
01
—
435212000
CHAMPUS/TRICARE
GA
05
—
890633G
—
NC
Enumeration date
06/24/2006
Last updated
05/07/2014
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