Individual
DAVID ANTHONY DE LA SIERRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
528 S 8TH ST, GRIFFIN, GA 30224-4212
(770) 467-1224
(770) 467-1225
Mailing address
P.O. BOX 28170, MACON, GA 31221-8170
(478) 254-5943
(478) 254-6093
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
056820
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
382655211A
—
GA
01
—
P00734398
MEDICARE RAILROAD
GA
Enumeration date
08/30/2006
Last updated
03/24/2014
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