Healthcare Provider Details

I. General information

NPI: 1063520377
Provider Name (Legal Business Name): DAVID ALAN CAUSEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 09/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 N BROAD ST
WINDER GA
30680-2150
US

IV. Provider business mailing address

4412 SUGAR MAPLE PL
GAINESVILLE GA
30506-4303
US

V. Phone/Fax

Practice location:
  • Phone: 770-867-3400
  • Fax: 770-688-3880
Mailing address:
  • Phone: 770-561-5404
  • Fax: 706-867-4158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number019496
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: