Individual
NICHOLAS WEBSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
39 KENT RD STE 5, TIFTON, GA 31794-1697
(229) 353-7337
Mailing address
39 KENT RD STE 5, TIFTON, GA 31794-1697
(229) 353-7337
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
83254
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/01/2016
Last updated
12/01/2020
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