Individual
GILBERT ANDREW KANDRAC JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
80 NEWNAN STATION DRIVE, SUITE A, NEWNAN, GA 30265
(770) 251-2060
(678) 854-9235
Mailing address
PO BOX 73709, NEWNAN, GA 30271-3709
(770) 251-2060
(678) 854-9235
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN105065
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
156961100
U.S. DEPT OF LABOR
GA
01
—
20-02624
UNITED HEALTHCARE
GA
01
—
52433809-002
BLUE CROSS BLUE SHIELD
GA
01
—
9975585
UNIVERSAL HEALTHCARE
GA
Enumeration date
09/01/2005
Last updated
04/17/2015
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