Organization
UPSON MEDICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WILLIAMS (CHIEF FINANCIAL OFFICER)
(706) 647-8111
Entity
Organization
Contact information
Practice address
100 HIGHWAY 18 W, BARNESVILLE, GA 30204-1713
(770) 358-9596
(706) 647-4389
Mailing address
PO BOX 589, THOMASTON, GA 30286-0008
(706) 647-8111
(706) 647-4389
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP6006
MEDICARE
GA
Enumeration date
06/16/2011
Last updated
06/16/2011
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