Individual
DALE WING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2621 E PINETREE BLVD, THOMASVILLE, GA 31792-4840
(229) 584-4100
(229) 584-5955
Mailing address
2621 E PINETREE BLVD, THOMASVILLE, GA 31792-4840
(229) 584-4100
(229) 584-5955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
068022
GA
207Q00000X
Family Medicine Physician
15430
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122485
—
MS
Enumeration date
04/26/2006
Last updated
08/05/2020
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