Individual
JOHN WILLIAM DEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2501 N PATTERSON ST, VALDOSTA, GA 31602-1735
(229) 259-4602
(229) 249-5063
Mailing address
PO BOX 3606, VALDOSTA, GA 31604-3606
(229) 259-4602
(229) 249-5063
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
0042409
FL
2085R0203X
Therapeutic Radiology Physician
Primary
027048
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000311066A
—
GA
Enumeration date
05/31/2005
Last updated
10/13/2011
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