Provider Demographics
NPI:1811067820
Name:LUMPKIN COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:LUMPKIN COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT HEALTH DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTFALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-535-5743
Mailing Address - Street 1:60 MECHANICSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533
Mailing Address - Country:US
Mailing Address - Phone:706-867-2727
Mailing Address - Fax:706-867-2739
Practice Address - Street 1:60 MECHANICSVILLE RD
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533
Practice Address - Country:US
Practice Address - Phone:706-867-2727
Practice Address - Fax:706-867-2739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000051972IMedicaid
GA000058638AMedicaid
GA000442945JMedicaid
GA000453109IMedicaid
GA000456442FMedicaid
GAD31310Medicare UPIN
GA000456442FMedicaid