Anderson, John David

Anderson, John David is an sole proprietor health care provider with primary practice located at 2704 N Oak St Bldg O, Valdosta GA 31602-1744. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Anderson, John David can be contacted via phone (229) 247-2350.

Contact Information

Primary practice address
2704 N Oak St Bldg O Valdosta GA 31602-1744
Fax: (229) 247-6826
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X GA021630 Georgia

Profile Details

NPI number 1316947484
LBN Legal business name Anderson, John David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 29th, 2005
Last updated Dec 17th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316947484 NPPES
Georgia MEDICAID 00229919C
Georgia Other 11D0265529
Georgia MEDICAID 2641658-01

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