Digestive Disorders & Liver Clinic of So Ga, PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

034811 Issued in GA

Legal business name

DIGESTIVE DISORDERS & LIVER CLINIC OF SO GA, PC

Practice address

907 E. 18TH Street
Suite 460
Tifton, GA 31794

Phone

(229) 391-3625

Fax

(229) 391-3639

NPI assigned

Jun 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael J. Dawson, M.D.

Title

President

Phone

(229) 391-3625

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279065600000",
    "number": "1871520148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 E. 18TH STREET",
            "address_2": "SUITE 460",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "31794",
            "telephone_number": "229-391-3625",
            "fax_number": "229-391-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 E. 18TH STREET",
            "address_2": "SUITE 460",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "31794",
            "telephone_number": "229-391-3625",
            "fax_number": "229-391-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE DISORDERS & LIVER CLINIC OF SO GA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2010-07-14",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-391-3625",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "034811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00473734F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William H Davis, MD
• Larry Day
• Sandra Day, L.D.O
• Roxann Elaine Deen, FNP-C
• Sanjay Desai, DO
• DM. Me Medical Supply Company
• Dogwood Pharmacy LLC
• Dogwood Pharmacy LTC
• Henry Clayton Dorminey Jr., M.D.
• Shyann Dorough, OTR/L

• Gastroenterology Physician in Tifton, GA
• Providers in Tifton, GA by specialty
• Gastroenterology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; 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.