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Individual

JOHNNY M BELENCHIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2705 E PINETREE BLVD STE C, THOMASVILLE, GA 31792-4875
(229) 584-5731
(229) 228-2492
Mailing address
900 CAIRO RD, THOMASVILLE, GA 31792-4255

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
071207
GA
207RP1001X
Pulmonary Disease Physician
11332
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00124286
MS
05
003142520A
GA
05
003142520B
GA
05
1419672
LA
01
1559353
AMERICAN ADMIN GROUP
MS
01
290013888
RAILROAD MEDICARE
Enumeration date
07/27/2006
Last updated
09/18/2020
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