Provider Demographics
NPI:1164694980
Name:EDWIN C. POUND, III MD PC
Entity type:Organization
Organization Name:EDWIN C. POUND, III MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:CURRIER
Authorized Official - Last Name:POUND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-256-1400
Mailing Address - Street 1:48 HARALSON PL STE 1
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512-3023
Mailing Address - Country:US
Mailing Address - Phone:404-256-1400
Mailing Address - Fax:706-835-1365
Practice Address - Street 1:48 HARALSON PL STE 1
Practice Address - Street 2:
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512-3023
Practice Address - Country:US
Practice Address - Phone:404-256-1400
Practice Address - Fax:706-835-1365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0290732086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF24304Medicare UPIN