Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mio Yanagisawa

Individual provider Surgery Physician · NPI 1376955831

Mio Yanagisawa is a General Surgery in Fayetteville, Georgia. Graduated from University of Texas Southwestern Medical School at Dallas in 2014, 12 years ago. Practices with Piedmont Providers LLC, a 518-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Georgia and Pennsylvania.

Years since qualifying
12
Trained at
University of Texas Southwestern Medical School at Dallas
Licensed in
GA, PA
In the registry since
2014
Specialties on file
3

Practice location Address checks out

1279 Highway 54 W Ste 100
Fayetteville, GA 30214-4551
Phone: (770) 719-5710
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 2315 Stockton Blvd, Sacramento, CA 95817-2201 — (916) 734-2011
  • 1365 Clifton Rd Ne Bldg C, Atlanta, GA 30322-1013 — (404) 778-3307
  • 22 St Paul Dr Ste 207, Chambersburg, PA 17201-1036 — (717) 709-6599
  • 450 S Washington St, Gettysburg, PA 17325-2500 — (717) 709-6599

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 85457 (GA)
Surgery Physician Taxonomy 208600000X · Licence MD492547 (PA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1376955831
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 2, 2014
Last updated in NPPESNovember 3, 2025
Certification dateNovember 3, 2025
Mailing address1365 Clifton Rd Ne Bldg C, Atlanta, GA 30322-1013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolUNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduated 2014 (12 years in practice)
Group practice Piedmont Providers Llc — 518 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fayetteville