Individual
JUSTIN THOMAS ERTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
707 PINE ST, MACON, GA 31201-2106
(478) 301-5820
(478) 301-5825
Mailing address
707 PINE ST, MACON, GA 31201-2106
(478) 301-5820
(478) 301-5825
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
78296
GA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/10/2014
Last updated
07/21/2022
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