Taxonomy Codes
                        The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
                        
                            
                                
                                    
                                        | No. | 
                                        Taxonomy Code | 
                                        Taxonomy Clasification | 
                                        Taxonomy Specialization | 
                                        License Number | 
                                        License State | 
                                        Primary | 
                                    
                                
                                
                                    | 1 | 1223S0112X | Dentist | Oral and Maxillofacial Surgery | DN012723 | GEORGIA | No | 
| 2 | 207YS0123X | Otolaryngology | Facial Plastic Surgery | 64391 | GEORGIA | No | 
| 3 | 2082S0099X | Plastic Surgery | Plastic Surgery Within the Head and Neck | 64391 | GEORGIA | No | 
| 4 | 204E00000X | Oral & Maxillofacial Surgery |  | 64391 | GEORGIA | Yes |