Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 011058 | GA |
NPI | 1003850926 |
---|---|
Provider Name | Ashburn P Searcy |
First Address | Kennesaw, GA 30152-4006 |
Second Address | Dallas, GA 30132-1335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D41935 | (02) |