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Individual

DR. RONALD CLINTON ATWATER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1178 5TH ST SE, CAIRO, GA 39828-3141
(229) 377-2002
Mailing address
1178 5TH ST SE, CAIRO, GA 39828-3141
(229) 377-2002

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
72406
GA
390200000X
Student in an Organized Health Care Education/Training Program
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003148404A
GA
Enumeration date
07/14/2009
Last updated
09/17/2020
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