Individual
MR. GREGORY E DODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
454 SMITH AVE, THOMASVILLE, GA 31792-5535
(229) 227-5510
(229) 227-5527
Mailing address
PO BOX 1479, THOMASVILLE, GA 31799-1479
(229) 227-5510
(229) 227-5527
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA693
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000147B
—
GA
05
—
291323200
—
FL
Enumeration date
07/05/2006
Last updated
07/30/2009
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