Venable, Roger John
Venable, Roger John is an sole proprietor health care provider with primary practice located at 163 S Tallahassee St , Hazlehurst GA 31539-6465. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Venable, Roger John can be contacted via phone (912) 375-7781.Contact Information
Primary practice address
163 S Tallahassee St
Hazlehurst GA 31539-6465
Phone: (912) 375-7781
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 21437 | Georgia |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 21437 | Georgia |
Profile Details
| NPI number | 1538384953 |
|---|---|
| LBN Legal business name | Venable, Roger John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 13th, 2007 |
| Last updated | Mar 7th, 2023 - about last year |
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 | 1538384953 | NPPES |
| Georgia | Other | 21437 | STATE MEDICAL LICENSE NUM |
| Georgia | MEDICAID | 00205521D | STATE MEDICAL LICENSE NUM |
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