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Individual

DR. MARY GRACE SOON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4370 W MAIN ST, DOTHAN, AL 36305-1056
(334) 793-5000
Mailing address
6005 N POINTE DR, COLUMBUS, GA 31909-3890
(706) 888-3485

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
060322
GA
208M00000X
Hospitalist Physician
MD-14409
HI
208M00000X
Hospitalist Physician
Primary
MD.33053
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
912934550E
GA
01
MD-14409
LIC
HI
Enumeration date
06/20/2007
Last updated
03/21/2016
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