Healthcare Provider Details

I. General information

NPI: 1063680031
Provider Name (Legal Business Name): GEORGE NELSON GUILD III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2008
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 HOWARD FARM DR STE 200
CUMMING GA
30041-6081
US

IV. Provider business mailing address

2000 HOWARD FARM DR STE 200
CUMMING GA
30041-6081
US

V. Phone/Fax

Practice location:
  • Phone: 770-758-8964
  • Fax: 770-292-6535
Mailing address:
  • Phone: 770-758-8964
  • Fax: 770-292-6535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number0002767
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: