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Individual

BRUCE G. HOUSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2002 PALMYRA RD, SUITE 101, ALBANY, GA 31701-1591
(229) 889-9367
(229) 317-0678
Mailing address
PO BOX 505, ALBANY, GA 31702-0505
(229) 889-9367
(229) 317-0678

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
033166
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000434772B
GA
01
110182702
RR MEDICARE PROVIDER #
GA
Enumeration date
09/19/2005
Last updated
01/23/2008
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