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General NPI Number Information
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NPI Number | 1205962065
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Entity Type | Individual
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Provider Name | JOANN RAY WEBSTER M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 214 PROFESSIONAL CIR UNIT A
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City | SAINT MARYS
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State | GA
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Zip | 31558-3733
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Country | US
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Telephone | 912-576-1015
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Fax | 904-321-2685
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Provider Business Mailing Address
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Address Line | 944A KINGS BAY ROAD #121
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City | SAINT MARYS
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State | GA
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Zip | 31558
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Country | US
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Telephone | 912-576-1015
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Fax | 904-321-2685
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 47512
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License Number State | GA
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