MEDICARE: DEBBIE ALLSUP GARRETT M.C.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	231H00000X	Audiologist	1250	GA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972597177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBBIE ALLSUP GARRETT M.C.D

Provider Business Mailing Address
First Line	:	107 JOHN MADDOX DR NW
Second Line	:
City	:	ROME
State	:	GA
Zip	:	30165-1419
Country	:	US
Telephone Number	:	706-235-0116
Fax Number	:	706-235-7008

Provider Business Practice Location Address
First Line	:	107 JOHN MADDOX DR NW
Second Line	:
City	:	ROME
State	:	GA
Zip	:	30165-1419
Country	:	US
Telephone Number	:	706-235-0116
Fax Number	:	706-235-7008

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

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	08/02/2011

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Directions to “ DEBBIE ALLSUP GARRETT M.C.D” Practice Location

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