# SOUTHEAST GEORGIA GASTROENTEROLOGY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891912713
- **Authorized official:** DR. AHMAD IRFAN MD (PRESIDENT)
- **Authorized official phone:** (912) 284-1210

## Contact information

- **Practice address:** 2003 PIONEER ST \# A, WAYCROSS, GA 31501-6249
- **Practice address phone:** (912) 284-1210
- **Mailing address:** 2003 PIONEER ST \# A, WAYCROSS, GA 31501-6249
- **Mailing address phone:** (912) 284-1210

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | 041584 | GA | Yes |

## Other

- **Enumeration date:** 04/20/2007
- **Last updated:** 08/22/2020