Individual
DR. JUSTIN MYGATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
300 E HOSPITAL RD, FORT GORDON, GA 30905
(706) 787-2862
(706) 787-7201
Mailing address
300 E HOSPITAL RD, FORT GORDON, GA 30905
(706) 787-2862
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101259456
VA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
02/27/2014
Last updated
09/29/2023
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