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Individual

DR. JOHN JOSEPH LAND IV

Active
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Individual

DR. JOHN JOSEPH LAND IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
DPM0000000417
TN
213E00000X
Podiatrist
Primary
POD000679
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000828385A
—
GA
01
—
1440694
UMWA
—
01
—
3124909
BCBS
TN
01
—
52432145
BC BS
GA
Enumeration date
10/27/2006
Last updated
02/27/2020
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