Individual
DR. ROGER JOHN VENABLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
163 S TALLAHASSEE ST, HAZLEHURST, GA 31539-6465
(912) 375-7781
Mailing address
PO BOX 117, CHESTER, GA 31012-0117
(478) 358-1740
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
21437
GA
207Q00000X
Family Medicine Physician
Primary
21437
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00205521D
—
GA
01
—
21437
STATE MEDICAL LICENSE NUM
GA
Enumeration date
04/13/2007
Last updated
03/07/2023
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