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General NPI Number Information
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NPI Number | 1164371415
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Entity Type | Organization
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Legal Business Name | GEORGIA HOSPITAL MEDICINE PHYSICIANS LLC
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 801 W GORDON ST
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City | THOMASTON
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State | GA
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Zip | 30286-3426
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Country | US
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Telephone | 337-581-6920
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 51473
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City | LAFAYETTE
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State | LA
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Zip | 70505-1473
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT
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Name | ALLYSON WIRTZ
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Credential |
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Telephone | 337-581-6920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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