Individual
DR. MARK ANDREW SUPAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
220 J L WHITE DR, SUITE 120, JASPER, GA 30143-4893
(706) 635-3539
Mailing address
220 J L WHITE DR, SUITE 120, JASPER, GA 30143-4893
(706) 692-3539
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
065503
GA
Other
Enumeration date
07/10/2007
Last updated
05/19/2011
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