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Individual

DR. JOHN T GANTOMASSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(478) 633-2147
(478) 742-9670
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
076027
GA
207L00000X
Anesthesiology Physician
336060
LA
207L00000X
Anesthesiology Physician
Primary
OS017509
PA
207LP3000X
Pediatric Anesthesiology Physician
336060
LA

Other

Enumeration date
05/27/2010
Last updated
01/19/2024
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