Grace T. Duque-Dizon, MD, PC

Organization Active NPI Pain Medicine (Anesthesiology) Physician · Eatonton, GA

NPI 1154488922 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1154488922
Entity type
Organization (NPI type 2)
Primary specialty
Pain Medicine (Anesthesiology) Physician 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
Organization subpart
No

Authorized official

Name
Grace T Duque Dizon, M.D.
Title
Owner - President
Phone
(478) 621-0905

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207LP2900X GA Yes

Addresses

Primary practice location

101 Greensboro Rd
Eatonton, GA 31024-6054

Mailing address

PO Box 4207
Macon, GA 31208-4207
Phone (478) 621-0905

Other identifiers

IdentifierTypeStateIssuer
DB9533OtherGARAIL ROAD MEDICARE GROUP

Other providers in Eatonton, GA

All providers in Eatonton, GA · Pain Medicine (Anesthesiology) Physician in Georgia

Sources for this page

Verify at the official NPI Registry.