Individual
DERRELL WINSOR ANGLYN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 SIMS ST, MCDONOUGH, GA 30253-2320
(770) 957-3922
(770) 957-5477
Mailing address
55 SIMS ST, MCDONOUGH, GA 30253-2320
(770) 957-3922
(770) 957-5477
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
024198
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00281487D
—
GA
Enumeration date
11/10/2006
Last updated
07/13/2011
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