Individual
GEORGE ALLEN WADDELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
559 VINCENT ST, ATTN: 21 AMDS/SGPF - AEROSP MED, PETERSON AFB, CO 80914-1540
(719) 556-1260
(866) 867-7926
Mailing address
559 VINCENT ST, ATTN: 21 AMDS/SGPF - AEROSP MED, PETERSON AFB, CO 80914-1540
(719) 556-1260
(866) 867-7926
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
07731
MS
2083A0100X
Aerospace Medicine Physician
Primary
07731
MS
Other
Enumeration date
04/14/2006
Last updated
03/25/2011
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