Provider Demographics
NPI:1497747570
Name:ATKINSON, GEORGE MICHAEL (MD)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:MICHAEL
Last Name:ATKINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15729
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39404-5729
Mailing Address - Country:US
Mailing Address - Phone:601-268-5144
Mailing Address - Fax:601-268-5149
Practice Address - Street 1:102 E HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1310
Practice Address - Country:US
Practice Address - Phone:601-268-5144
Practice Address - Fax:601-268-5149
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18485207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03137391Medicaid
I15196Medicare UPIN
MS180000322Medicare ID - Type Unspecified