Individual
JENNIFER SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
101 HARTFORD RD W STE 1, FORT GAINES, GA 39851-4331
(229) 210-2100
(478) 301-5812
Mailing address
250 MARTIN LUTHER KING JR BLVD, MACON, GA 31201-3490
(478) 301-2362
(478) 301-2272
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003047
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00073521G
—
GA
Enumeration date
05/27/2005
Last updated
11/23/2020
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