DIGESTIVE DISORDERS & LIVER CLINIC OF SO GA, PC (NPI# 1871520148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871520148 |
| Entity Type | Organization |
| Organization Name | DIGESTIVE DISORDERS & LIVER CLINIC OF SO GA, PC |
| Practice Address |
907 E. 18th Street Suite 460 Tifton GA 31794 |
| Practice Telephone | 2293913625 |
| Practice Fax Number | 2293913639 |
| Mailing Telephone | 2293913625 |
| Mailing Fax Number | 2293913639 |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2010-07-14 |
| Authorized Official Name | MR. MICHAEL J. DAWSON (PRESIDENT) |
| Authorized Official Telephone | 2293913625 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
034811 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00473734F | 05 |
| Street Address |
907 E. 18TH STREET SUITE 460 |
| City | TIFTON |
| State | GA |
| Zip Code | 31794 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134153711 | Michael J Dawson Jr. | Internal Medicine | 907 E. 18th Street, Suite 460, Tifton, GA 31794 | 2006-07-10 |
| 1508896705 | Tiftarea Endoscopy Center, Inc. | Clinic/Center | 907 E. 18th Street, Suite 460, Tifton, GA 31794 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234043 | Deloris Lunsford | Licensed Practical Nurse | 903 Washington St., Tifton, GA 31794 | 2020-01-17 |
| 1194383075 | William Jordan Kinnett | Registered Nurse | 1205 Tift Ave N, Tifton, GA 31794 | 2019-06-05 |
| 1598321200 | Courtlyn Christanna Fussell | Pharmacist | 2201 Hwy 41 N, Tifton, GA 31794 | 2019-05-17 |
| 1376027722 | Martha Gibbs | Nurse Practitioner | Affinity Clinic/west Campus, 2225 Us Hwy 41 North, Tifton, GA 31794 | 2018-09-21 |
| 1427541044 | Rebekah F Cottle | Speech-Language Pathologist | 2227 Highway 41 North, Tifton, GA 31794 | 2018-06-08 |
| 1790280857 | Tift Regional Health System Inc | Ophthalmology | 1803 Old Ocilla Road, Tifton, GA 31794 | 2018-03-29 |
| 1568975431 | Skyler Clark | Pharmacist | 2201 North 12th Street, Tifton, GA 31794 | 2017-11-14 |
| 1538606306 | Imagine Peace Counseling LLC | Counselor | 223 E 2nd Street, Suite B, Tifton, GA 31794 | 2017-01-31 |
| 1073056347 | Jessica Tumbling | Contractor | 219 Savannah Way, Tifton, GA 31794 | 2016-11-18 |
| 1992159503 | Joseph Thomas Seagraves Jr. | Nurse Practitioner | 901 East 18th Street, Tifton, GA 31794 | 2016-04-20 |
| Find all providers in zip 31794 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023011541 | Robert E Dale | Internal Medicine | 2225 Us Hwy 41 N, Tifton, GA 31794 | 2005-05-30 |
| 1760684013 | Ali Esmaili | Internal Medicine | 2225 Us Highway 41 N, Tifton, GA 31794-2749 | 2007-05-31 |
| 1528126182 | South Georgia Medicine, P.C. | Internal Medicine | 1111 20th St E, Tifton, GA 31794-3689 | 2006-12-05 |
| 1780755918 | Don Wayne Roberts | Internal Medicine | 1111 20th St E, Tifton, GA 31794-3689 | 2006-11-10 |
| 1134153711 | Michael J Dawson Jr. | Internal Medicine | 907 E. 18th Street, Suite 460, Tifton, GA 31794 | 2006-07-10 |
| 1023084449 | Matthew William Pantsari | Internal Medicine | 901 18th St E, Tifton, GA 31794-3648 | 2006-02-25 |
| 1790786226 | George Elias Yared | Internal Medicine | 2225 Us Highway 41 N, Tifton, GA 31794-2749 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730741448 | Gastro Consultants of Atlanta PC | Internal Medicine | 5669 Peachtree Dunwoody Rd Ste 270, Atlanta, GA 30342-1786 | 2019-07-02 |
| 1023582798 | Digestive Care Consultants, LLC | Internal Medicine | 11315 Johns Creek Pkwy Ste 400, Johns Creek, GA 30097-1517 | 2019-01-16 |
| 1285122465 | Atlanta Premier Gi Endoscopy, LLC | Internal Medicine | 3400 Mcclure Bridge Rd Ste B201, Duluth, GA 30096-8705 | 2018-04-24 |
| 1346762838 | Precision Medical Center PC | Internal Medicine | 4646 N Shallowford Rd Ste 555, Atlanta, GA 30338-6308 | 2017-07-17 |
| 1437510443 | Steven Caras | Internal Medicine | 2682 Bonaire Terrace, Marietta, GA 30066 | 2016-03-18 |
| 1922407162 | Umg Gastroenterology LLC | Internal Medicine | 820 Saint Sebastian Way Ste 2f, Augusta, GA 30901-2636 | 2014-08-13 |
| 1841618881 | Leah G Katta | Internal Medicine | 3400 Old Milton Pkwy Ste 380, Alpharetta, GA 30005-3707 | 2014-04-05 |
| 1306276324 | Candler Gastroenterology | Internal Medicine | 380b Cedar St, Metter, GA 30439-4042 | 2013-11-13 |
| 1215377247 | Deepanshu Jain | Internal Medicine | 8855 Hospital Dr Ste 101, Douglasville, GA 30134-2256 | 2013-07-05 |
| 1114260833 | Shahzad Ahmed | Internal Medicine | 1301 Sigman Rd Ne Ste 170, Conyers, GA 30012-3923 | 2013-04-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.