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1265612972
JONATHAN LANCE UNDERWOOD
VALDOSTA, GA
NPI
1265612972
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: GA 002394)
Enumeration Date
2007-11-09
Last Update Date
2011-06-23
Business Address
-- JONATHAN LANCE UNDERWOOD MD
3207 COUNTRY CLUB RD
VALDOSTA, GA 31605-1029
Phone number: 229-242-8480
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Mailing Address
-- JONATHAN LANCE UNDERWOOD MD
3207 COUNTRY CLUB RD
VALDOSTA, GA 31605-1029
Phone number: 229-242-8480
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