Provider Demographics
NPI:1720237803
Name:JOHN WHITE GARLAND, III, M.D.
Entity Type:Organization
Organization Name:JOHN WHITE GARLAND, III, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WHITE
Authorized Official - Last Name:GARLAND
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:770-287-5387
Mailing Address - Street 1:PO BOX 908504
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-0924
Mailing Address - Country:US
Mailing Address - Phone:770-287-5387
Mailing Address - Fax:770-532-9414
Practice Address - Street 1:1700 BLUE RIDGE DR NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-1208
Practice Address - Country:US
Practice Address - Phone:770-287-5387
Practice Address - Fax:770-532-9414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA105432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00183796AMedicaid
GAAG5004560OtherDEA
GA511G700864Medicare PIN
GA00183796AMedicaid