Medina, Jose

Medina, Jose is an sole proprietor health care provider with primary practice located at 3334 Greystone Way , Valdosta GA 31605. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Medina, Jose can be contacted via phone (229) 247-1667.

Contact Information

Primary practice address
3334 Greystone Way Valdosta GA 31605
Phone: (229) 247-1667
Fax: (229) 245-7661
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 041166 Georgia
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 041166 Georgia
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 041166 Georgia
Allopathic & Osteopathic Physicians / Sleep Medicine 207RS0012X 041166 Georgia

Profile Details

NPI number 1417944513
LBN Legal business name Medina, Jose
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 4th, 2005
Last updated Apr 19th, 2012 - about 12 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 1417944513 NPPES
Georgia MEDICAID 000686507C

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