MEDICARE: JOHN P. ERDMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	MD0000024929	TN
2	207Y00000X	Otolaryngology Physician	035251	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245220128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN P. ERDMAN MD

Provider Business Mailing Address
First Line	:	140 BATTLEWOOD DR
Second Line	:
City	:	FT OGLETHORPE
State	:	GA
Zip	:	30742-4006
Country	:	US
Telephone Number	:	706-861-7070
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 BATTLEWOOD DR
Second Line	:
City	:	FORT OGLETHORPE
State	:	GA
Zip	:	30742-4006
Country	:	US
Telephone Number	:	706-861-7070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	06/20/2019

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