Individual
ARTHUR J PROVISOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 10TH AVE, COLUMBUS, GA 31901
(706) 571-1120
(706) 660-1603
Mailing address
4750 WATERS AVE STE 103, SAVANNAH, GA 31404-6267
(912) 350-5646
(912) 350-7680
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
047358
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00834655B
—
GA
Enumeration date
11/08/2006
Last updated
08/06/2018
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