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NPI Code Detail

MEDICARE: ALDRICH VILLAMIN MENDOZA M.D.

MEDICARE: ALDRICH VILLAMIN MENDOZA 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
1207Q00000XFamily Medicine Physician062916GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437329661
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALDRICH VILLAMIN MENDOZA M.D.
Provider Business Mailing Address
First Line : PO BOX 1882
Second Line :
City : ROME
State : GA
Zip : 30162
Country : US
Telephone Number : 706-509-3000
Fax Number : 706-509-4600
Provider Business Practice Location Address
First Line : 251 HIGHWAY 53 E
Second Line :
City : CALHOUN
State : GA
Zip : 30701-3026
Country : US
Telephone Number : 706-625-4410
Fax Number : 706-625-4447
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2008
Last Update Date : 05/04/2011

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