Siddall, Brian Douglas

Siddall, Brian Douglas is an individual health care provider with primary practice located at 280 E Willow Creek Ln , Mc Rae GA 31055-5128. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Siddall, Brian Douglas can be contacted via phone (478) 864-3448.

Contact Information

Primary practice address
280 E Willow Creek Ln Mc Rae GA 31055-5128
Phone: (478) 864-3448
Fax: (478) 864-1288
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 023227 Georgia

Profile Details

NPI number 1205029352
LBN Legal business name Siddall, Brian Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2007
Last updated Oct 29th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205029352 NPPES
Georgia Other 23227 STATE LICENSE

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