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NPI Code Detail

MEDICARE: DR. STEVEN ANTHONY OLDER M.D.

MEDICARE:  DR. STEVEN ANTHONY OLDER  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
1207RR0500XRheumatology PhysicianG7093TX

General Provider Information

NPI Number : 1760589089
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN ANTHONY OLDER M.D.
Provider Business Mailing Address
First Line : 3534 W LAKE DR
Second Line :
City : MARTINEZ
State : GA
Zip : 30907-9530
Country : US
Telephone Number : 706-210-8751
Fax Number :
Provider Business Practice Location Address
First Line : 300 W HOSPITAL DR
Second Line : DWIGHT DAVID EISENHOWER ARMY MEDICAL CENTER
City : FT. GORDON
State : GA
Zip : 30905-5650
Country : US
Telephone Number : 706-787-6462
Fax Number : 706-787-0005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 07/08/2007

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Directions to “ DR. STEVEN ANTHONY OLDER M.D.” Practice Location

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