Healthcare Provider Details

I. General information

NPI: 1154339471
Provider Name (Legal Business Name): FINBAR FRANCIS WOITALLA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 CARLTON ST
ATHENS GA
30602-1503
US

IV. Provider business mailing address

55 CARLTON ST
ATHENS GA
30602-1503
US

V. Phone/Fax

Practice location:
  • Phone: 706-542-1162
  • Fax:
Mailing address:
  • Phone: 706-542-1162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number56000
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: