Istvan Balog, MD
Individual provider Active NPI Family Medicine Physician · Townsend, GA
NPI 1013900802 · NPPES record last updated Sep 3, 2014
Key facts
- NPI
- 1013900802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 025524 (GA)
- Practice address
- 1299 Ga Hwy 57
Between 1-95 and Hwy 17 @ Eulonia
Townsend, GA 31331-8128 - Phone
- (912) 832-4495
- Fax
- (912) 832-4852
- NPI assigned
- Aug 26, 2005
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091116000109 | GA | Practitioner - General Practice |
6800934647 | Practice locations: Towsend, GA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 025524 | GA | Yes |
Addresses
Primary practice location
1299 Ga Hwy 57
Between 1-95 and Hwy 17 @ Eulonia
Townsend, GA 31331-8128
Mailing address
147 Belle Point Pkwy
Brunswick, GA 31525-2174
Phone (912) 466-0766
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00293103A | Medicaid | GA |
Other providers in Townsend, GA
All providers in Townsend, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.