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General NPI Number Information
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NPI Number | 1992771661
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Entity Type | Individual
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Provider Name | A EUGENE WESTMORELAND JR. MD
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Gender | Male
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 08/29/2014
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Provider Practice Location Address
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Address Line | 479B N HALL RD
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City | DAHLONEGA
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State | GA
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Zip | 30533-0627
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Country | US
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Telephone | 706-864-7963
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Fax | 706-864-1588
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Provider Business Mailing Address
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Address Line | PO BOX 897
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City | DAHLONEGA
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State | GA
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Zip | 30533-0015
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Country | US
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Telephone | 706-864-7963
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Fax | 706-864-1588
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 013534
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License Number State | GA
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