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Organization

PATHOLOGY ASSOCIATES OF WAYCROSS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DWIGHT P MIRMOW MD (PRESIDENT)
(912) 287-1515
Entity
Organization

Contact information

Practice address
410 DARLING AVE, WAYCROSS, GA 31501-5246
(912) 287-1515
(912) 287-1394
Mailing address
PO BOX 1409, WAYCROSS, GA 31502-1409
(706) 287-1515
(912) 287-1394

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
GA

Other

Enumeration date
09/05/2005
Last updated
07/21/2022
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