Healthcare Provider Details

I. General information

NPI: 1497172787
Provider Name (Legal Business Name): JAMES GARRETT WEBSTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 06/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4120 N VALDOSTA RD STE A
VALDOSTA GA
31602
US

IV. Provider business mailing address

6431 FANNIN ST SUITE MSB 1.134
HOUSTON TX
77030-1501
US

V. Phone/Fax

Practice location:
  • Phone: 229-244-2068
  • Fax: 229-244-2850
Mailing address:
  • Phone: 713-500-6500
  • Fax: 713-500-6497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number080585
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: