Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath | ||
Y | 208200000X | Surgeon | 023386 | GA |
Y | 208600000X | Surgeon | 023386 | GA |
NPI | 1598727968 |
---|---|
Provider Name | Dr. John A Mansberger |
First Address | Thomasville, GA 31799-3329 |
Second Address | Thomasville, GA 31792-4876 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2006 |
Last Update Date | 05/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B66840 | (02) | GA |