Organization
PATHOLOGY ASSOCIATES OF VALDOSTA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WILLIAM HANSON M.D. (PRESIDENT)
(229) 245-0447
Entity
Organization
Contact information
Practice address
2001 N PATTERSON ST, VALDOSTA, GA 31602-2944
(229) 245-0447
(229) 245-0448
Mailing address
PO BOX 3287, VALDOSTA, GA 31604-3287
(229) 245-0447
(229) 245-0448
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J307285
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CF4854
RR MEDICARE
GA
01
—
N357819
MEDICAID WELLCARE
GA
Enumeration date
05/24/2006
Last updated
11/08/2010
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