Provider Demographics
NPI:1518073998
Name:AUSTIN, STEVEN K (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:K
Last Name:AUSTIN
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 1:1436 BROADRICK DR STE B
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-3009
Mailing Address - Country:US
Mailing Address - Phone:706-226-3434
Mailing Address - Fax:706-226-4820
Practice Address - Street 1:1436 BROADRICK DR STE B
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3009
Practice Address - Country:US
Practice Address - Phone:706-226-3434
Practice Address - Fax:706-226-4820
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22043207RI0011X
GA44399207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000741408BMedicaid
TN3073909Medicaid
TN3076909Medicaid
TN3073909Medicaid
GA000741408BMedicaid
TN3073909Medicare PIN