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DR. THOMAS JOHN BACKENSON M.D.

>> Allergy & Immunology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1568562759

Individual Registrant:
DR. THOMAS JOHN BACKENSON M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
7950 MARTIN LOOP MARTIN ARMY COMMUNITY HOSPITAL FORT BENNING, GA 31905-5647 US
Tel: 706-544-2203  Fax: --

Contact information for business:
4754 WINGED FOOT WAY  COLUMBUS, GA 31909-8009 US
Tel: --  Fax: --

Registration Information:
NPI: 1568562759
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207K00000XAllopathic & Osteopathic Physicians
Allergy & Immunology
DCMD034380

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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