Provider Demographics
NPI:1689619678
Name:MCCASKILL, GEORGE LEE (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:LEE
Last Name:MCCASKILL
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 1:2415 PARKWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4722
Mailing Address - Country:US
Mailing Address - Phone:912-466-7188
Mailing Address - Fax:912-466-7185
Practice Address - Street 1:2415 PARKWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4722
Practice Address - Country:US
Practice Address - Phone:912-466-7187
Practice Address - Fax:912-466-7185
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29624207QA0505X
GA063689207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259539700Medicaid
SC296245Medicaid
FL58619OtherBLUE CROSS & BLUE SHIELD
SCAA17767924Medicare PIN
P00775866Medicare PIN
SCAA17768580Medicare PIN
G81598Medicare UPIN
SC296245Medicaid