MEDICARE: CURTIS SORENSEN MD

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	207P00000X	Emergency Medicine Physician	39947	GA
2	207Q00000X	Family Medicine Physician	39947	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	930103530	OTHER	GA	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	001543	OTHER	GA	BLUE CROSS

General Provider Information

NPI Number	:	1457381089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CURTIS SORENSEN MD

Provider Business Mailing Address
First Line	:	100 BROOKSTONE CENTRE PKWY
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-2990
Country	:	US
Telephone Number	:	706-653-0835
Fax Number	:	706-653-8069

Provider Business Practice Location Address
First Line	:	100 BROOKSTONE CENTRE PKWY
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-2990
Country	:	US
Telephone Number	:	706-653-0835
Fax Number	:	706-653-8069

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	04/27/2017

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Directions to “ CURTIS SORENSEN MD” Practice Location

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