Organization
JOHN A VANLANDINGHAM, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA VANLANDINGHAM R.N. (BUSINESS MANAGER)
(251) 296-1849
Entity
Organization
Contact information
Practice address
1301 BELLEVILLE AVE, BREWTON, AL 36426-1306
(251) 296-1849
Mailing address
PO BOX 430, FLOMATON, AL 36441-0430
(251) 296-1849
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6207
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110557
UNITED HEALTH CARE
AL
01
—
51006483
BLUE CROSS BLUE SHIELD
AL
01
—
J966
MEDICARE GROUP ID
AL
Enumeration date
03/03/2008
Last updated
03/03/2008
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