L M. Gustafson M.D.
Otolaryngology Physician in Carrollton, GA(View on Map)
Full Name
L Mark Gustafson M.D.
NPI Number
1073555629
NPI Type
Individual Provider
Gender
Male
Enumeration Date
06/11/2006
Specialties
(Taxonomies)Licenses
State
Georgia
License Number
049795
Contact
Information
Purpose
Mailing
Location
Address
150 CLINIC AVE
150 CLINIC AVE
City
Carrollton
Carrollton
State
GA
GA
Postal Code
30117-4401
30117-4401
Country
US
US
Telephone Number
(770) 832-1488
(770) 832-1488
Identifiers
Identifier
841043
00906463C
00906463B
Identifier State
GA
GA
GA
Identifier Issuer
BLUE CROSS CLUE SHIELD
Unknown
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/18/2022
Provider Address
Other Otolaryngology Physicians in Carrollton, Georgia:
Christopher Harper MD
Carrollton, GASpecialties: Otolaryngology Physician (Primary)Student in an Organized Health Care Education/Training Program
Thomas Comstock M.D.
Carrollton, GASpecialties: Otolaryngology Physician (Primary)General Practice PhysicianOccupational Medicine Physician