Grogan, David K

Grogan, David K is an individual health care provider with primary practice located at 216 Corder Rd , Warner Robins GA 31088. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Grogan, David K can be contacted via phone (478) 923-5872.

Contact Information

Primary practice address
216 Corder Rd Warner Robins GA 31088
Fax: (478) 922-9020
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 002483 Georgia

Profile Details

NPI number 1841294386
LBN Legal business name Grogan, David K
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Jun 13th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841294386 NPPES
Georgia MEDICAID 100000536A
Georgia Other 970028283

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