MEDICARE: DR. ALAN D JUSTICE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	032405	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110150410	OTHER	GA	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1114955572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN D JUSTICE M.D.

Provider Business Mailing Address
First Line	:	2675 WINKLER AVE STE 200
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9328
Country	:	US
Telephone Number	:	877-856-3774
Fax Number	:	239-599-2612

Provider Business Practice Location Address
First Line	:	446 POPLAR ST STE B
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31201-3336
Country	:	US
Telephone Number	:	478-746-0097
Fax Number	:	478-742-4051

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	04/30/2026

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Directions to “ DR. ALAN D JUSTICE M.D.” Practice Location

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