Provider Demographics
NPI:1023005121
Name:VALDEZ, FELIX G (MD)
Entity Type:Individual
Prefix:DR
First Name:FELIX
Middle Name:G
Last Name:VALDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2501 N PATTERSON ST
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-1735
Mailing Address - Country:US
Mailing Address - Phone:229-259-4501
Mailing Address - Fax:229-259-4502
Practice Address - Street 1:2501 N PATTERSON ST
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1735
Practice Address - Country:US
Practice Address - Phone:229-259-4501
Practice Address - Fax:229-259-4502
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA050565207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00921555AMedicaid
GA11BDTRMMedicare PIN
GAH43132Medicare UPIN