Provider Demographics
NPI:1023310703
Name:GEORGE L. AUBLEY M.D.,PC
Entity type:Organization
Organization Name:GEORGE L. AUBLEY M.D.,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:FURGIUELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-449-3767
Mailing Address - Street 1:6460 SPALDING DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-1805
Mailing Address - Country:US
Mailing Address - Phone:770-449-6320
Mailing Address - Fax:770-409-8457
Practice Address - Street 1:6460 SPALDING DR
Practice Address - Street 2:SUITE A
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-1805
Practice Address - Country:US
Practice Address - Phone:770-449-6320
Practice Address - Fax:770-409-8457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030262174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00365472BMedicaid
GA00365472BMedicaid