Individual
CALVIN EDWARD DEFENBAU IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3834
(678) 207-4373
(770) 533-4727
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 533-4786
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN209756
GA
363LF0000X
Family Nurse Practitioner
Primary
APRN-NP209756
GA
Other
Enumeration date
06/30/2018
Last updated
10/30/2025
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