Individual
DR. DOUGLAS B WIDENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1495 HICKORY FLAT HWY STE 200, CANTON, GA 30115-4229
(678) 505-4455
(678) 505-4446
Mailing address
1495 HICKORY FLAT HWY STE 200, CANTON, GA 30115-4229
(678) 505-4455
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
063452
GA
Other
Enumeration date
06/27/2008
Last updated
09/15/2020
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