Individual
JOHN G VACHTSEVANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1240 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3861
(770) 532-7202
(678) 450-3778
Mailing address
1240 JESSE JEWELL PKWY STE 300, GAINESVILLE, GA 30501
(770) 532-7202
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
046269
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20NCCHB
MEDICARE PTAN
GA
Enumeration date
11/29/2005
Last updated
09/28/2023
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