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General NPI Number Information
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NPI Number | 1073624763
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Entity Type | Organization
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Legal Business Name | JAMES T. SANDWICH, M.D., P.C.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 06/18/2015
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Provider Practice Location Address
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Address Line | 450 LANIER AVE W
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-1502
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Country | US
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Telephone | 770-460-8988
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Fax | 770-460-0727
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Provider Business Mailing Address
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Address Line | 450 LANIER AVE W
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-1502
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Country | US
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Telephone | 770-460-8988
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Fax | 770-460-0727
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES THOMAS SANDWICH
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Credential | M.D.
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Telephone | 770-460-6194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | GA36609
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License Number State | GA
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