Individual
DR. JOHN C HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9355 MAIN ST S, NAHUNTA, GA 31553-6159
(912) 462-6222
(912) 462-6203
Mailing address
100 S MADISON ST, THOMASVILLE, GA 31792-5473
(229) 520-7115
(229) 236-0871
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
011959
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00038651A
—
GA
01
—
032781
BLUESHIELD
GA
Enumeration date
09/20/2006
Last updated
03/02/2016
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