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Individual

WILLIAM G IRWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
212 HOSPITAL DR, STE C, WARNER ROBINS, GA 31088-4207
(478) 922-9281
(478) 328-0438
Mailing address
2400 BELLEVUE RD, SUITE 21-A, DUBLIN, GA 31021-2885
(478) 275-7202
(478) 274-8418

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
012172
GA
207ND0900X
Dermatopathology Physician
012172
GA
207NP0225X
Pediatric Dermatology Physician
012172
GA
207NS0135X
Procedural Dermatology Physician
012172
GA
208D00000X
General Practice Physician
012172
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0007629024
GA
01
DC4061
RAILROAD MEDICARE
GA
01
P00167982
RAILROAD MEDICARE
GA
Enumeration date
09/08/2005
Last updated
04/23/2015
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