Individual
DAVID A RIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
808 BEACON ST, WAYCROSS, GA 31501-7104
(912) 490-4325
(912) 490-7673
Mailing address
808 BEACON ST, WAYCROSS, GA 31501-7104
(912) 490-4325
(912) 490-9673
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
PA06880
TX
363A00000X
Physician Assistant
Primary
PA06880
TX
363AM0700X
Medical Physician Assistant
PA068880
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299686001
—
TX
01
—
877N37
BCBS
TX
Enumeration date
02/15/2006
Last updated
07/02/2020
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