Individual
DAVID K GROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
216 CORDER RD, WARNER ROBINS, GA 31088
(478) 923-5872
(478) 922-9020
Mailing address
216 CORDER RD, WARNER ROBINS, GA 31088-3604
(478) 923-5872
(478) 922-9020
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002483
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000536A
—
GA
01
—
970028283
RR MEDICARE
GA
Enumeration date
06/13/2005
Last updated
06/13/2018
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