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General NPI Number Information
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NPI Number | 1164510244
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Entity Type | Individual
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Provider Name | DEANNA SETTERS SANDERS PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1824 LEE AVE
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City | TIFTON
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State | GA
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Zip | 31794-3639
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Country | US
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Telephone | 229-556-6320
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Fax | 229-353-6343
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Provider Business Mailing Address
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Address Line | 88 SANDHAMMOCK LAKE RD
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City | TIFTON
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State | GA
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Zip | 31793-6847
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Country | US
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Telephone | 229-353-6320
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Fax | 229-353-6343
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 002903
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License Number State | GA
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