George Allen Waddell Jr., M.D.

Primary specialty

Aerospace Medicine PhysicianTaxonomy code 2083A0100X

License

07731 Issued in MS

Practice address

559 Vincent St
Attn: 21 Amds/SGPF - Aerosp Med
Peterson AFB, CO 80914-1540

Phone

(719) 556-1260

Fax

(866) 867-7926

NPI assigned

Apr 14, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301011200000",
    "number": "1215991476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST",
            "address_2": "ATTN: 21 AMDS/SGPF - AEROSP MED",
            "city": "PETERSON AFB",
            "state": "CO",
            "postal_code": "809141540",
            "telephone_number": "719-556-1260",
            "fax_number": "866-867-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST",
            "address_2": "ATTN: 21 AMDS/SGPF - AEROSP MED",
            "city": "PETERSON AFB",
            "state": "CO",
            "postal_code": "809141540",
            "telephone_number": "719-556-1260",
            "fax_number": "866-867-7926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "GEORGE",
        "middle_name": "ALLEN",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2011-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "07731",
            "primary": false
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "MS",
            "license": "07731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen L Travers, MD
• Edward Joseph Tucholski Jr., DDS
• Jeffrey A Turner, DPT
• Francesca Vasta-Falldorf, DDS
• Kim Lee Vehige, LCSW
• Monique McWilliams Wall, LCSW
• Travis Paul Waters, PA-C
• John Franklin Watkins III, DENTIST DDS
• Irene Ai-Ling Wiles, PH.D.
• Jefferie Michael Wilson, MD

• Aerospace Medicine Physician in Peterson AFB, CO
• Providers in Peterson AFB, CO by specialty
• Aerospace Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.