Individual
SIDNEY R WASHINGTON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1878 BRANNEN LAKE RD, STATESBORO, GA 30458-7257
(912) 690-2724
(912) 852-2041
Mailing address
1878 BRANNEN LAKE RD, STATESBORO, GA 30458-7257
(912) 690-2724
(912) 852-2041
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
028667
GA
208D00000X
General Practice Physician
28667
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000326136A
—
GA
Enumeration date
04/11/2006
Last updated
01/23/2014
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