Provider Demographics
NPI:1316141328
Name:GEORGE C PURSLEY MD
Entity type:Organization
Organization Name:GEORGE C PURSLEY MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:C
Authorized Official - Last Name:PURSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-726-8727
Mailing Address - Street 1:1219 W WHEELER PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-1899
Mailing Address - Country:US
Mailing Address - Phone:706-726-8727
Mailing Address - Fax:706-426-0384
Practice Address - Street 1:1219 W WHEELER PKWY STE A
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-1899
Practice Address - Country:US
Practice Address - Phone:706-726-8727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00391399QMedicaid
GA11BDLFNMedicare PIN
GA00391399QMedicaid