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JOHN DAVID ANDERSON MD
>> Internal Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1316947484
Individual Registrant: JOHN DAVID ANDERSON MD
Gender: M
Sole Proprietor
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
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
Tel: 229-247-2350 Fax: 229-247-6826
Registration Information:
NPI: 1316947484
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207R00000X | Allopathic & Osteopathic Physicians Internal Medicine | GA | GA021630 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 2641658-01 | FL | 05 | |
| 00229919C | GA | 05 | |
| CLIA | 11D0265529 | 01 |
