Provider Demographics
NPI:1396988754
Name:ANDO, REBECCA BEDINGFIELD (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:BEDINGFIELD
Last Name:ANDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:JAYNE
Other - Last Name:BEDINGFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-0658
Mailing Address - Country:US
Mailing Address - Phone:770-718-1122
Mailing Address - Fax:770-535-7445
Practice Address - Street 1:725 JESSE JEWELL PKWY SE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3834
Practice Address - Country:US
Practice Address - Phone:770-297-2200
Practice Address - Fax:770-534-8139
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA073898207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003170305CMedicaid
GA1176583OtherWELLCARE
GA999999OtherBCBS
GA003170305FMedicaid
GA003170305EMedicaid
GA035382023OtherAMERIGROUP
GA99999OtherUNITEDHEALTHCARE
GA99999OtherTRICARE
GA003170305GMedicaid
GA99999OtherHUMANA
GA999999OtherCIGNA
GA003170305BMedicaid
GA99999OtherPEACH STATE
GA999999OtherMULTIPLAN
GA003170305AMedicaid
GA003170305DMedicaid
GA999999OtherAETNA & COVENTRY
GA99999OtherTRICARE