Individual provider Active NPI

Lawrence F Kulish, MD

  • Family Medicine Physician
  • Dawsonville, GA
National Provider Identifier
1467437913
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
045860 Issued in GA
Practice address
35 Lumpkin Campground Rd N
Dawsonville, GA 30534-6206
Phone
(706) 216-6446
Fax
(706) 216-6457
NPI assigned
Dec 7, 2005
Last updated
Mar 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 045860 GA Primary

Addresses

Primary practice location

35 Lumpkin Campground Rd N
Dawsonville, GA 30534-6206

Mailing address

663 Gold Creek Dr
Dawsonville, GA 30534-3181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060817000364 GA Practitioner - Emergency MedicinePractitioner - Family Practice 3375455512 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
045860GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southland Emergency Medical Services Consolidated, LLC Family Medicine CurrentSince Nov 27, 2023 Accepting new patients
Southland Consolidated Emergency Services, LLC CurrentSince Jul 31, 2023 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Dec 1, 2020 Accepting new patients
Allergy and ENT of Ga Family Medicine Past Accepting new patients
Chestatee Emergency Physicians, LLC Past Accepting new patients

Locations

145 E Peacock St
Cochran, GA 31014
Phone (229) 200-4950

541 441 Historic Hwy N
Demorest, GA 30535
Phone (706) 839-4000

4 Medical Dr
Elberton, GA 30635
Phone (706) 213-2527

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

610 Sparta Rd
Sandersville, GA 31082
Phone (478) 240-2000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1467437913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 GOLD CREEK DR",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305343181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 LUMPKIN CAMPGROUND RD N",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346206",
            "telephone_number": "706-216-6446",
            "fax_number": "706-216-6457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULISH",
        "first_name": "LAWRENCE",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "045860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dawsonville, GA

Sources for this page

Verify at the official NPI Registry.