Provider Demographics
NPI:1649290099
Name:MOSBY, JOHN A III (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:MOSBY
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:7015 POLO DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-7008
Mailing Address - Country:US
Mailing Address - Phone:478-202-7273
Mailing Address - Fax:478-239-0094
Practice Address - Street 1:2733 SHERATON DR STE 110
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-6850
Practice Address - Country:US
Practice Address - Phone:478-202-7273
Practice Address - Fax:706-484-1978
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2025-05-08
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Provider Licenses
StateLicense IDTaxonomies
GA042671207Q00000X
SC23681207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCH97266Medicare UPIN