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General NPI Number Information
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NPI Number | 1285444596
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Entity Type | Individual
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Provider Name | LANDON DAVID WITHERS PALMER FNP
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Gender | Male
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 3486 PEACH ORCHARD RD STE 100
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City | AUGUSTA
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State | GA
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Zip | 30906-5215
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Country | US
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Telephone | 706-828-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 215 CAROLETON DR
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City | GROVETOWN
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State | GA
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Zip | 30813-0317
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Country | US
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Telephone | 435-851-5717
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN305476
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License Number State | GA
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