Dale Wing, MD
Individual provider Active NPI Family Medicine Physician · Thomasville, GA
NPI 1720045552 · NPPES record last updated Aug 5, 2020
Key facts
- NPI
- 1720045552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 068022 (GA)
- Practice address
- 2621 E Pinetree Blvd
Thomasville, GA 31792-4840 - Phone
- (229) 584-4100
- Fax
- (229) 584-5955
- NPI assigned
- Apr 26, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Mississippi School of Medicine, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Archbold Medical Group, Inc.
Practice addresses (Care Compare)
100 Mimosa Dr
Thomasville, GA 31792-6676
Phone (229) 228-5500
2621 E Pinetree Blvd
Thomasville, GA 31792-4840
Phone (229) 584-4100
Hospital & facility affiliations
- Centerwell Home Health
- Archbold Home Health Services
- Hospice of Southwest Georgia
- Georgia Hospice Care
- Archbold Memorial Hospital
- Archbold Living Thomasville
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120716000045 | GA | Practitioner - Family Practice | 1951492610 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 068022 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Archbold Medical Group | Current |
Accepting new patients | |
| Archbold Medical Group, Inc. | Current |
Accepting new patients | |
| Archbold Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Locations
900 Cairo Rd
Thomasville, GA 31792
Phone (229) 227-5102
100 Mimosa Dr
Thomasville, GA 31792
Phone (229) 226-9141
116 Mimosa Dr
Thomasville, GA 31792
Phone (229) 551-0083
2621 E Pinetree Blvd
Thomasville, GA 31792
Phone (229) 226-5788
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 15430 | MS | |
| Family Medicine Physician | 207Q00000X | 068022 | GA | Yes |
Addresses
Primary practice location
2621 E Pinetree Blvd
Thomasville, GA 31792-4840
Mailing address
2621 E Pinetree Blvd
Thomasville, GA 31792-4840
Phone (229) 584-4100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00122485 | Medicaid | MS |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dale.wing.p16@direct.archbold.nextgenshare.com |
Other providers in Thomasville, GA
- Elizabeth Robin Wilson
- Holly Marie Wilson
- Kristen Nicole Wilson
- Sarah Wilson
- Matthew Ross Winfree
- Robin Wise
- Rachel Wolverton
- Davis Andrew Wood
- Mark Gregory Wood
- Mary E Woolfolk
All providers in Thomasville, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.