Provider Demographics
NPI:1154401107
Name:GARCIA, VERA C (MD)
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:C
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4370 KINGS WAY STE E
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-6905
Mailing Address - Country:US
Mailing Address - Phone:229-247-7767
Mailing Address - Fax:229-247-7626
Practice Address - Street 1:4370 KINGS WAY STE E
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602
Practice Address - Country:US
Practice Address - Phone:229-247-7767
Practice Address - Fax:229-247-7626
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA54375207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA874346206AMedicaid
GA08BBRBFMedicare PIN