David W Duvall, MD

Individual provider Active NPI Internal Medicine Physician · Cordele, GA

NPI 1750335774 · NPPES record last updated Mar 22, 2018

Key facts

NPI
1750335774
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
021498 (GA)
Practice address
201 E 16TH Ave
Cordele, GA 31015-1623
Phone
(229) 273-8501
Fax
(229) 273-2515
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Crisp General Internal Medicine Inc Internal Medicine Past
since Jan 1, 2018
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 021498 GA Yes

Addresses

Primary practice location

201 E 16TH Ave
Cordele, GA 31015-1623

Mailing address

PO Box 5785
Cordele, GA 31010
Phone (229) 273-8501

Other identifiers

IdentifierTypeStateIssuer
000220107EMedicaidGA

Other providers in Cordele, GA

All providers in Cordele, GA · Internal Medicine Physician in Georgia

Sources for this page

Verify at the official NPI Registry.