Provider Demographics
NPI:1235517137
Name:BESSOM, NATALIE
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:
Last Name:BESSOM
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:HOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1107 MEMORIAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-8662
Mailing Address - Country:US
Mailing Address - Phone:706-226-9355
Mailing Address - Fax:706-226-9380
Practice Address - Street 1:1107 MEMORIAL DR STE 200
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720
Practice Address - Country:US
Practice Address - Phone:706-226-9355
Practice Address - Fax:706-226-9380
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT016323207Q00000X
GA080343207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine