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Individual
JOHN G VANSAVAGE
Active
Individual
JOHN G VANSAVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
14153R
LA
208800000X
Urology Physician
Primary
32546
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1189413
—
LA
01
—
340019044
RAILROAD MEDICARE
LA
Enumeration date
06/20/2005
Last updated
07/21/2022
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