Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 066091 | GA |
N | 208600000X | Surgeon | 066091 | GA |
Y | 2086S0102X | Surgical Critical Care | 066091 | GA |
N | 2086S0127X | Trauma Surgeon | 066091 | GA |
NPI | 1134370711 |
---|---|
Provider Name | Dr. Luttrell L Toussaint |
First Address | Lawrenceville, GA 30046-3370 |
Second Address | Lawrenceville, GA 30046-7694 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2008 |
Last Update Date | 29/10/2020 |