Provider Demographics
NPI:1679557953
Name:BILLIAN, CARL (MD)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:
Last Name:BILLIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 RED BUD RD NE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-2077
Mailing Address - Country:US
Mailing Address - Phone:706-879-4789
Mailing Address - Fax:706-879-5769
Practice Address - Street 1:1035 RED BUD RD NE
Practice Address - Street 2:SUITE 102
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-2077
Practice Address - Country:US
Practice Address - Phone:706-879-4789
Practice Address - Fax:706-879-5769
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0421802084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000710498UMedicaid
GA00710498AMedicaid
GAF56658Medicare UPIN
GA13BDCQLMedicare ID - Type Unspecified
GA00710498AMedicaid