Provider Demographics
NPI:1184792897
Name:GEORGE P HATZIGEORGIS PROFESSIONAL ASSOCIATION
Entity type:Organization
Organization Name:GEORGE P HATZIGEORGIS PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF ASSOCIATION
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:PANAYIOTIS
Authorized Official - Last Name:HATZIGEORGIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-933-8025
Mailing Address - Street 1:1617 11TH AVENUE SOUTH
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205
Mailing Address - Country:US
Mailing Address - Phone:205-933-8025
Mailing Address - Fax:
Practice Address - Street 1:1617 11TH AVENUE SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205
Practice Address - Country:US
Practice Address - Phone:205-933-8025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5841208600000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========35205A001OtherTRICARE
C70755Medicare UPIN