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JOHN DAVID ANDERSON MD

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1316947484

Individual Registrant:
 JOHN DAVID ANDERSON MD
Gender: M
Sole Proprietor

Location and contact information for practice:
2704 N OAK ST BLDG O VALDOSTA, GA 31602-1744 US
Tel: 229-247-2350  Fax: 229-247-6826

Contact information for business:
2704 N OAK ST BLDG O VALDOSTA, GA 31602-1744 US
Tel: 229-247-2350  Fax: 229-247-6826

Registration Information:
NPI: 1316947484
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
GAGA021630

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
2641658-01FL05
00229919CGA05
CLIA11D026552901




HEALTH CARE JOBS GA - Page 1



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