Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 027054 | GA |
N | 207X00000X | Orthopaedic Surgeon | 13386 | AL |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 027054 | GA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MD.13386 | AL |
NPI | 1063451391 |
---|---|
Provider Name | Dr. Frederick C. Flandry |
First Address | Fortson, GA 31808-0370 |
Second Address | Columbus, GA 31909-3540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 20/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C75365 | (02) |