Individual
DR. SOMSAK WATTANAWANAKUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
369 FAIRGROUND RD, SWAINSBORO, GA 30401-3821
(478) 299-0001
Mailing address
369 FAIRGROUND RD, SWAINSBORO, GA 30401-3821
(478) 299-0001
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
022913
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00292179K
—
GA
Enumeration date
03/08/2007
Last updated
07/25/2016
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