George Timothy Cassidy, PA-C
Individual provider Active NPI Physician Assistant · Fort Eisenhower, GA
NPI 1578623799 · NPPES record last updated Jan 30, 2025
Key facts
- NPI
- 1578623799
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 300 W Hospital Rd
Fort Eisenhower, GA 30905-5741 - Phone
- (706) 787-2720
- Fax
- (706) 787-6829
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160809002821 | GA | Order and Referring Only - Physician Assistant | 2062706351 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
300 W Hospital Rd
Fort Eisenhower, GA 30905-5741
Mailing address
300 W Hospital Rd
Fort Eisenhower, GA 30905-5741
Phone (706) 787-5302
Other providers in Fort Eisenhower, GA
- Leslee Nichole Browning
- Lauren Geeter Bursey
- John Price Caldwell Sr.
- Christina Janelle Campo Ford
- Jane Emily Carnett
- Chloe Chai
- Gary Chen
- Joyce Ann Clem
- Alicia Clement
- Sylvester Cobbina
All providers in Fort Eisenhower, GA · Physician Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2025. 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.