Individual
BRETT WALLENTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 OAKHURST DR, EVANS, GA 30809-3650
(706) 364-5500
(706) 364-6863
Mailing address
PO BOX 2628, EVANS, GA 30809-2628
(706) 364-5500
(706) 364-6863
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
046334
GA
Other
Enumeration date
02/12/2007
Last updated
07/09/2007
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