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:
Health care specialties
Specialty | Code | License # | 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 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1417944513 | NPPES |
Georgia | MEDICAID | 000686507C |
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