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General NPI Number Information
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NPI Number | 1518024363
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Entity Type | Organization
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Legal Business Name | GREGORY H ESSELMAN MD LLC
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 03/10/2015
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Provider Practice Location Address
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Address Line | 121 AURORA PLACE SUITE B
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City | AIKEN
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State | SC
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Zip | 29801-3000
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Country | US
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Telephone | 706-868-5676
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Fax | 706-722-2824
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Provider Business Mailing Address
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Address Line | 340 NORTH BELAIR ROAD
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City | EVANS
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State | GA
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Zip | 30809-3000
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Country | US
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Telephone | 706-868-5676
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Fax | 706-722-2824
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Authorized Official
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Title or Position | BILLING SUPERVISOR
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Name | JAMMIE L SPARKS
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Credential | CPC
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Telephone | 706-868-5676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 29469
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License Number State | SC
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