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General NPI Number Information
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NPI Number | 1245201250
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Entity Type | Individual
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Provider Name | GEORGINA KESTERSON MD
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Gender | Female
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Dates
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Enumeration Date | 01/28/2006
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 10579 BENT TREE VW
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City | JOHNS CREEK
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State | GA
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Zip | 30097-5988
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Country | US
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Telephone | 901-482-0207
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Fax | 828-484-2057
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Provider Business Mailing Address
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Address Line | 10579 BENT TREE VW
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City | JOHNS CREEK
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State | GA
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Zip | 30097-5988
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Country | US
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Telephone | 901-482-0207
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Fax | 828-484-2057
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 22804
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 27587
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 33167
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License Number State | GA
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