Organization
DIGESTIVE DISORDERS & LIVER CLINIC OF SO GA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J. DAWSON M.D. (PRESIDENT)
(229) 391-3625
Entity
Organization
Contact information
Practice address
907 E. 18TH STREET, SUITE 460, TIFTON, GA 31794
(229) 391-3625
(229) 391-3639
Mailing address
907 E. 18TH STREET, SUITE 460, TIFTON, GA 31794
(229) 391-3625
(229) 391-3639
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
034811
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00473734F
—
GA
Enumeration date
06/26/2006
Last updated
07/14/2010
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