Provider Demographics
NPI:1164694980
Name:EDWIN C. POUND, III MD PC
Entity Type:Organization
Organization Name:EDWIN C. POUND, III MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:POUND
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:404-256-1400
Mailing Address - Street 1:993 JOHNSON FERRY RD NE
Mailing Address - Street 2:#210C
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1620
Mailing Address - Country:US
Mailing Address - Phone:404-256-1400
Mailing Address - Fax:404-256-1412
Practice Address - Street 1:993 JOHNSON FERRY RD NE
Practice Address - Street 2:#210C
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1620
Practice Address - Country:US
Practice Address - Phone:404-256-1400
Practice Address - Fax:404-256-1412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0290732086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF24304Medicare UPIN