Provider Demographics
NPI:1023249760
Name:JEFFREY D. ESSLINGER, MD, PC
Entity type:Organization
Organization Name:JEFFREY D. ESSLINGER, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:ESSLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-386-5330
Mailing Address - Street 1:300 COURTYARD DR SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-8535
Mailing Address - Country:US
Mailing Address - Phone:770-386-5330
Mailing Address - Fax:770-382-7536
Practice Address - Street 1:300 COURTYARD DR SE
Practice Address - Street 2:SUITE A
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-8535
Practice Address - Country:US
Practice Address - Phone:770-386-5330
Practice Address - Fax:770-382-7536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000696261QP2300X
GA45455261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAR61765Medicare UPIN
GAG98516Medicare UPIN