Provider Demographics
NPI:1427267988
Name:JOHN W AKRIDGE MD PC
Entity type:Organization
Organization Name:JOHN W AKRIDGE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:AKRIDGE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:912-283-1699
Mailing Address - Street 1:PO BOX 275
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31502-0275
Mailing Address - Country:US
Mailing Address - Phone:912-283-1699
Mailing Address - Fax:912-283-1971
Practice Address - Street 1:1096 WOOD VALLEY RD
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31503-8586
Practice Address - Country:US
Practice Address - Phone:912-283-1699
Practice Address - Fax:912-283-1971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0273362085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADG2740OtherRAILROAD MEDICARE
GADG2740OtherRAILROAD MEDICARE
GAGRP6266Medicare PIN