Individual
BRISANDI VILLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
901 18TH ST E, TIFTON, GA 31794-3648
(229) 382-7120
Mailing address
3100 OAK GROVE RD, ATTN: MEDICAL STAFF SERVICES, POPLAR BLUFF, MO 63901-1573
(573) 776-9752
(573) 776-9027
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
99998
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2021
Last updated
05/21/2024
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