Provider Demographics
NPI:1922276955
Name:GEORGE, NOEL JOSEPH JR (NP)
Entity Type:Individual
Prefix:MR
First Name:NOEL
Middle Name:JOSEPH
Last Name:GEORGE
Suffix:JR
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:
Practice Address - Street 1:2351 PHILLIPS RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5333
Practice Address - Country:US
Practice Address - Phone:508-778-1668
Practice Address - Fax:850-877-0431
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN3089402363LA2200X, 363LA2200X
NJ26NJ00126300363LA2200X
NVTAPRN701240363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024440900Medicaid
NV1922276955Medicaid