Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Valdosta State University

Organization Sports Medicine (Orthopaedic Surgery) Physician · NPI 1962787804

Valdosta State University is a Sports Medicine (Orthopaedic Surgery) Physician in Valdosta, Georgia. Registered with an NPI since 2011.

In the registry since
2011
Specialties on file
2

Practice location Address checks out

1500 N Patterson St
Valdosta, GA 31698-0100
Phone: (229) 333-5897
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Orthopaedic Surgery) Physician (primary) Taxonomy 207XX0005X
Athletic Trainer Taxonomy 2255A2300X

Record details

NPI number1962787804
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jay Johnson — Head Athletic Trainer · (229) 333-5897
Other names Valdosta State University Sports Medicine
NPI enumeratedOctober 11, 2011
Last updated in NPPESDecember 19, 2022
Certification dateDecember 19, 2022
Mailing address1500 N Patterson St, Valdosta, GA 31698-0100