Provider Demographics
NPI:1881884260
Name:WAHL, GEORGIA MCADAMS (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGIA
Middle Name:MCADAMS
Last Name:WAHL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16389
Mailing Address - Street 2:FGH TRAUMA SURGERY CLINIC
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39404-6389
Mailing Address - Country:US
Mailing Address - Phone:601-288-2690
Mailing Address - Fax:601-288-2695
Practice Address - Street 1:6059 HWY 49 S
Practice Address - Street 2:FORREST GENERAL HOSPITAL
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39404-6389
Practice Address - Country:US
Practice Address - Phone:601-288-2890
Practice Address - Fax:601-288-2695
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD200367208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1070891Medicaid
LA33047OtherCDS
LA33047OtherCDS