Provider Demographics
NPI:1760412308
Name:HOUSER, JOHN WESLEY III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WESLEY
Last Name:HOUSER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 70843
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30007-0843
Mailing Address - Country:US
Mailing Address - Phone:404-699-1353
Mailing Address - Fax:404-699-5919
Practice Address - Street 1:2600 MARTIN LUTHER KING JR DR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-1636
Practice Address - Country:US
Practice Address - Phone:404-699-1353
Practice Address - Fax:404-699-5919
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2010-12-16
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Provider Licenses
StateLicense IDTaxonomies
GA019056207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00160245AMedicaid
GA00160245AMedicaid