Healthcare Provider Details

I. General information

NPI: 1104368141
Provider Name (Legal Business Name): UNION GENERAL AFFILIATED SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2016
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 MAIN ST
YOUNG HARRIS GA
30582-4315
US

IV. Provider business mailing address

35 HOSPITAL RD
BLAIRSVILLE GA
30512-3139
US

V. Phone/Fax

Practice location:
  • Phone: 706-439-6873
  • Fax: 706-439-6874
Mailing address:
  • Phone: 706-439-6873
  • Fax: 706-439-6874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NICK TOWNSEND
Title or Position: CFO
Credential:
Phone: 706-439-6469