Devine, John William

Devine, John William is an individual health care provider with primary practice located at 2501 N Patterson St , Valdosta GA 31602-1735. He recently has only one registered license in Allopathic & Osteopathic Physicians / Therapeutic Radiology, which is considered as his primary health care specialty. Devine, John William can be contacted via phone (229) 259-4602.

Contact Information

Primary practice address
2501 N Patterson St Valdosta GA 31602-1735
Phone: (229) 259-4602
Fax: (229) 249-5063
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Therapeutic Radiology 2085R0203X 027048 Georgia
Allopathic & Osteopathic Physicians / Therapeutic Radiology 2085R0203X 0042409 Florida

Profile Details

NPI number 1578566964
LBN Legal business name Devine, John William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated Oct 13th, 2011 - about 13 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 1578566964 NPPES
Georgia MEDICAID 000311066A

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