Individual
ABEGAIL TATE DISMUKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5665 NEW NORTHSIDE DR STE 320, ATLANTA, GA 30328-5834
(770) 874-5400
Mailing address
102 ORCHARD CIR, DOTHAN, AL 36305-5814
(334) 797-3774
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10579
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/24/2021
Last updated
09/07/2021
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