Individual
LINDA DIANNE FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
939 BOB ARNOLD BLVD, SUITE A, LITHIA SPRINGS, GA 30122-3258
(770) 944-9852
(770) 944-1043
Mailing address
PO BOX 1248, LITHIA SPRINGS, GA 30122-1165
(770) 944-9852
(770) 944-1043
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
017051
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00531946A
—
GA
01
—
0468089
AETNA
GA
01
—
239704
BLUE CROSS BLUE SHIELD
GA
01
—
7406929
UNITED HEALTHCARE
GA
Enumeration date
08/30/2006
Last updated
07/29/2008
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