Individual
JOHN VENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-3071
(706) 721-8084
Mailing address
1499 WALTON WAY, SUITE 1400, AUGUSTA, GA 30901-2602
(706) 724-6100
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
042475
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000712027A
—
GA
05
—
G60296
—
SC
Enumeration date
08/31/2006
Last updated
11/25/2014
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