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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

L MARK GUSTAFSON, M.D.

Active

Otolaryngology · CARROLLTON, GA

Registration Details

NPI Number
1073555629
Provider Type
Individual
Gender
Male
NPI Issued
Jun 11, 2006 (19.864233539397 yrs)
Last Updated
Jul 18, 2022
License
049795 (GA)

Practice Information

Address
150 CLINIC AVE
SUITE 201
CARROLLTON, GA, 301174401
Browse GA providers · Browse ZIP 30117
Phone
7708321488
Primary Specialty
Otolaryngology
207Y00000X

Other Otolaryngology Providers in CARROLLTON, GA

Name Credential NPI
JOHN C PEZOLD M.D. 1245272806
DR. THOMAS COMSTOCK M.D. 1164576534
DR. WILLIAM BRADLEY GAMBRELL M.D. 1013056985
DR. CHRISTOPHER W. HARPER JR. MD 1407201486
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.