in Sandersville - Medical

- NPI 1003073990

is a Medical in Sandersville, Georgia. practices all healthcare services and medical treatments related to Medical. The NPI Number for is 1003073990. The last update date is .

's current location address is 501 Sparta Rd Ste F, Sandersville, Georgia. You can contact this provider via phone number 4785520001 and fax number 4785520048. The mailing address for is 501 Sparta Rd Ste F, Sandersville, Georgia. To know further, please read the information below!

Provider Profile Detail

Provider Name
Address 501 Sparta Rd Ste F, Sandersville, Georgia
Phone Number 4785520001
Fax Number 4785520048
Sole Proprietor --
Credentials --

NPI Number Detail

NPI Number 1003073990
Provider Enumeration Date
Last Updated Date

Provider Mailing Address Detail

Address 501 Sparta Rd Ste F
City Sandersville
State Georgia (GA)
Post Code 310821392
Phone Number 4785520001
Fax Number 4785520048

Provider's Primary Taxonomy Detail

Speciality Medical
Taxonomy 363Am0700X
Licence No 1722
Definition:
A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment.

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
899248448B GA --
899248448A GA --

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