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General NPI Number Information
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NPI Number | 1982561114
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Entity Type | Organization
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Legal Business Name | VITAL HEALTH ASSOCIATES OF GEORGIA LLC
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 130 N GROSS RD STE 201
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City | KINGSLAND
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State | GA
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Zip | 31548-6277
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Country | US
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Telephone | 912-729-2795
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Fax | 912-729-4117
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Provider Business Mailing Address
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Address Line | 330 CORPORATE WAY STE 200
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City | ORANGE PARK
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State | FL
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Zip | 32073-6214
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Country | US
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Telephone | 904-282-6331
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Fax | 904-866-4818
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Authorized Official
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Title or Position | CEO
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Name | ANDREW CHRISTMAN
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Credential |
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Telephone | 904-282-6331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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