Larry L Medders, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

019078 Issued in GA

Practice address

2319 Prince Ave
Athens, GA 30606-6030

Phone

(706) 354-1625

Fax

(706) 543-4155

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 9, 2007.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1316965221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2319 PRINCE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066030",
            "telephone_number": "706-354-1625",
            "fax_number": "706-543-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2319 PRINCE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066030",
            "telephone_number": "706-354-1625",
            "fax_number": "706-543-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDDERS",
        "first_name": "LARRY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "019078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew McRae Jr., DMD
• Angela S McSwain, MD
• Mary Kathryn McSwain
• Andrea Maclin Mealor, NP
• Daniel L Measel, MD
• Medical Center Anesthesiology of Athens
• Medical Office Force
• Medical Supply Assistance, LLC
• Medicap Pharmacy
• Charles Thomas Medlin Jr.

• All providers in Athens, GA
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.