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NPI Code Detail

MEDICARE: SIDNEY R WASHINGTON III MD

MEDICARE: SIDNEY R WASHINGTON III MD
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
1174400000XSpecialist028667GA
2208D00000XGeneral Practice Physician28667GA

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 : 1538122478
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIDNEY R WASHINGTON III MD
Provider Business Mailing Address
First Line : 1878 BRANNEN LAKE RD
Second Line :
City : STATESBORO
State : GA
Zip : 30458-7257
Country : US
Telephone Number : 912-690-2724
Fax Number : 912-852-2041
Provider Business Practice Location Address
First Line : 1878 BRANNEN LAKE RD
Second Line :
City : STATESBORO
State : GA
Zip : 30458-7257
Country : US
Telephone Number : 912-690-2724
Fax Number : 912-852-2041
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2006
Last Update Date : 01/23/2014

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Directions to “ SIDNEY R WASHINGTON III MD” Practice Location

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