Grace T. Duque-Dizon, MD, PC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

GRACE T. DUQUE-DIZON, MD, PC

Practice address

101 Greensboro Rd
Eatonton, GA 31024-6054

Phone

(478) 621-0905

Fax

(478) 742-0854

NPI assigned

Jan 2, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Grace T Duque Dizon, M.D.NPI 1306823034

Title

Owner - President

Phone

(478) 621-0905

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Grace Duque-Dizon, M.D.

  • Interventional Pain Medicine Physician
  • Macon, GA
  • NPI 1306823034
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154488922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4207",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312084207",
            "telephone_number": "478-621-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 GREENSBORO RD",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310246054",
            "telephone_number": "478-621-0905",
            "fax_number": "478-742-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE T. DUQUE-DIZON, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUQUE DIZON",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER - PRESIDENT",
        "authorized_official_telephone_number": "478-621-0905",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jameelah Jean Gater, MD
• Georgia CVS Pharmacy, L.L.C. (CVS Pharmacy # 07744)
• Golden Links Healthcare LLC
• Stacey Lyn Gothard, MED CCC-SLP
• Grace and Mercy Life Coach, LLC
• Desiree Green
• Greensboro Sports, Spine, & (Greensboro Sports, Spine & Wellness)
• Eric Gregory, DC
• Taylor Ellen Hall, FNP
• Hannah Meigan Miller DMD LLC

• Pain Medicine (Anesthesiology) Physician in Eatonton, GA
• Providers in Eatonton, GA by specialty
• Pain Medicine (Anesthesiology) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.