is a Surgery in Vidalia, Georgia. practices all healthcare services and medical treatments related to Surgery. The NPI Number for is 1760692388. The last update date is .
's current location address is Po Box 1047, Vidalia, Georgia. You can contact this provider via phone number 9125388545. The mailing address for is Po Box 1047, Vidalia, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | Po Box 1047, Vidalia, Georgia |
| Phone Number | 9125388545 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1760692388 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | Po Box 1047 |
|---|---|
| City | Vidalia |
| State | Georgia (GA) |
| Post Code | 304751047 |
| Phone Number | 9125388545 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Surgery |
|---|---|
| Taxonomy | 208600000X |
| Licence No | 54933 |
|
Definition: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| GRP6799 | GA | MEDICARE GROUP NUMBER |
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