Individual
DR. DAVID RANDAL FOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., D.M.D.
Contact information
Practice address
1060 GAFFNEY RD #7440, BASSETT ARMY COMMUNITY HOSPITAL, FT WAINWRIGHT, AK 99703-1474
(907) 361-6028
Mailing address
3010 CASTLEWOODS DR, MACON, GA 31204-1474
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DN009804
FL
207R00000X
Internal Medicine Physician
00015943
AL
207R00000X
Internal Medicine Physician
Primary
034591
GA
Other
Enumeration date
03/08/2006
Last updated
07/31/2017
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