MEDICARE: DR. GEORGE MILTON MCCLUSKEY III M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	30342	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	20NCCRR	OTHER	GA	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	52255395-006	OTHER	GA	BLUE CROSS BLUE SHIELD OF GEORGIA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	601-05060	OTHER	AL	BLUE CROSS BLUE SHILED OF ALABAMA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205817467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE MILTON MCCLUSKEY III M.D.

Provider Business Mailing Address
First Line	:	2300 MANCHESTER EXPY STE 2001A
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-6802
Country	:	US
Telephone Number	:	706-320-3126
Fax Number	:	706-320-3054

Provider Business Practice Location Address
First Line	:	2300 MANCHESTER EXPY
Second Line	:	STE 101A
City	:	COLUMBUS
State	:	GA
Zip	:	31904-6802
Country	:	US
Telephone Number	:	706-322-2462
Fax Number	:	706-322-2891

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	08/07/2024

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Directions to “ DR. GEORGE MILTON MCCLUSKEY III M.D.” Practice Location

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