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DR. BRIAN DOUGLAS SIDDALL M.D.

>> General Practice >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1205029352

Individual Registrant:
DR. BRIAN DOUGLAS SIDDALL M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
280 E WILLOW CREEK LN  MC RAE, GA 31055-5128 US
Tel: 478-864-3448  Fax: 478-864-1288

Contact information for business:
PO BOX 371 2251 WEST ELM STREET WRIGHTSVILLE, GA 31096-0371 US
Tel: 478-864-3448  Fax: 478-864-1288

Registration Information:
NPI: 1205029352
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y208D00000XAllopathic & Osteopathic Physicians
General Practice
GA023227

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
STATE LICENSE23227GA01




HEALTH CARE JOBS GA - Page 1



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