Austin, Gordon T
Austin, Gordon T is an individual health care provider with primary practice located at 819 Dixie St , Carrollton GA 30117-4415. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Austin, Gordon T can be contacted via phone (770) 832-7374.Contact Information
Primary practice address
819 Dixie St
Carrollton GA 30117-4415
Phone: (770) 832-7374
Fax: (770) 832-7260
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 8598 | Georgia |
Profile Details
| NPI number | 1477551257 |
|---|---|
| LBN Legal business name | Austin, Gordon T |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2005 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477551257 | NPPES |
| Georgia | MEDICAID | 00380784A |
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