Basic Information
Provider Information | |||||||||
NPI: | 1245220680 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | FLOWERS | ||||||||
FirstName: | GEORGE | ||||||||
MiddleName: | ADAM | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 9151 ESTATE THOMAS | ||||||||
Address2: | FOOTHILLS PROFESIONAL BUILDING #206 | ||||||||
City: | ST THOMAS | ||||||||
State: | VI | ||||||||
PostalCode: | 008022617 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3407792663 | ||||||||
FaxNumber: | 3407792443 | ||||||||
Practice Location | |||||||||
Address1: | 9151 ESTATE THOMAS | ||||||||
Address2: | FOOTHILLS PROFESIONAL BUILDING #206 | ||||||||
City: | ST THOMAS | ||||||||
State: | VI | ||||||||
PostalCode: | 008022617 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3407792663 | ||||||||
FaxNumber: | 3407792443 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 10/26/2005 | ||||||||
LastUpdateDate: | 08/20/2015 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 200300469 | NC | N |   | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |   | 207XX0005X | 200300469 | NC | N |   | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | 207X00000X | 1706 | VI | N |   | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |   | 207XX0005X | 1706 | VI | Y |   | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
ID Information
ID | Type | State | Issuer | Description | 0382260001 | 01 |   | DMERC MEDICARE | OTHER | 89134JN | 05 | NC |   | MEDICAID | P00085692 | 01 |   | RAILROAD MEDICARE | OTHER | 802974 | 01 |   | PARTNERS MEDICARE | OTHER | 1706 | 01 | VI | VI LICENSE | OTHER | 134JN | 01 |   | BCBS | OTHER | 6697422 | 01 |   | CIGNA | OTHER | 2208423 | 01 |   | UNITED HEALTHCARE | OTHER | 7109346 | 01 |   | AETNA | OTHER |