Individual
GEORGE GATEWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPO,CPED
Contact information
Practice address
2403 MANCHESTER EXPY, COLUMBUS, GA 31904-6813
(706) 596-8004
(706) 327-3388
Mailing address
PO BOX 1623, FORTSON, GA 31808-1623
(706) 596-8004
(706) 327-3388
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2253
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00919553A
—
GA
01
—
138773
PEACHSTATE
GA
01
—
N343442
WELLCARE
GA
Enumeration date
01/23/2007
Last updated
11/02/2007
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