Provider Demographics
NPI:1770566515
Name:HATSIOS, GEORGE JOHN (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:JOHN
Last Name:HATSIOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:839 MAJESTIC CT STE 4
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-5152
Mailing Address - Country:US
Mailing Address - Phone:704-867-8021
Mailing Address - Fax:704-867-8021
Practice Address - Street 1:620 SUMMIT CROSSING PL
Practice Address - Street 2:SUITE 106
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2176
Practice Address - Country:US
Practice Address - Phone:704-867-8021
Practice Address - Fax:704-864-4606
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2000004502085N0904X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89126PJMedicaid
300110410OtherRAILROAD MEDICARE
1643192OtherUNITED HEALTHCARE
2353084OtherAETNA HMO
37296OtherPARTNERS
SCN00452Medicaid
126PJOtherBLUE CROSS BLUE SHIELD
7837131OtherAETNA PPO
98467OtherMEDCOST
300110410OtherRAILROAD MEDICARE
2353084OtherAETNA HMO