Individual
DR. NAZARIO VILLASENOR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
106 ALLEN ST, CUMMING, GA 30040-2602
(678) 455-8693
Mailing address
PO BOX 80883, ATHENS, GA 30608-0883
(706) 549-8114
(706) 549-8114
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
64985
GA
207LA0401X
Addiction Medicine (Anesthesiology) Physician
64985
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
64985
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003110098B
—
GA
Enumeration date
06/06/2007
Last updated
05/14/2013
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