Provider Demographics
NPI:1619675261
Name:BERBESSI, GEORGE EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:EDWARD
Last Name:BERBESSI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 BARBER CREEK DR BLDG 200
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-4500
Mailing Address - Country:US
Mailing Address - Phone:706-548-8984
Mailing Address - Fax:706-383-7781
Practice Address - Street 1:1050 BARBER CREEK DR BLDG 200
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-4500
Practice Address - Country:US
Practice Address - Phone:706-548-8984
Practice Address - Fax:706-383-7781
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010971111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor