Individual
DAVID G DILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 HAWTHORNE AVE, SUITE O, ATHENS, GA 30606-2168
(706) 353-0093
(706) 353-0094
Mailing address
PO BOX 1728, WATKINSVILLE, GA 30677-0034
(706) 353-0093
(706) 353-0094
Taxonomy
Speciality
Code
Description
License number
State
207YX0602X
Otolaryngic Allergy Physician
Primary
040364
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00681227K
—
GA
01
—
040015437
MEDICARE RAILROAD ID NO
GA
01
—
040364
STATE LICENSE NUMBER
GA
01
—
196754
BCBS PROVIDER NUMBER
GA
Enumeration date
04/24/2006
Last updated
01/15/2013
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