Individual provider · Type 1 NPI

Leah M. Waller, PA

Medical Physician Assistant · Vidalia, GA

NPI number 1962873711 Active

Practice location

1 Meadows Pkwy
Vidalia, GA 30474-8759

Call (912) 535-5800 Map

Fax (912) 535-5830

Mailing address

PO Box 407
Vidalia, GA 30475-0407

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X007734 (GA)

Medical Physician Assistant: Definition to come...

44 other providers at this address

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About NPI 1962873711

Leah M. Waller, PA's National Provider Identifier is 1962873711, issued on Oct 19, 2015. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Vidalia, GA. The record was last updated on Oct 17, 2019.