Healthcare Provider Details
I. General information
NPI: 1689765307
Provider Name (Legal Business Name): GEORGE DAVID ZORET MD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/27/2006
Last Update Date: 10/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
207 BENEDICT RD
BRUNSWICK GA
31520-2939
US
IV. Provider business mailing address
207 BENEDICT RD
BRUNSWICK GA
31520-2939
US
V. Phone/Fax
- Phone: 912-267-6270
- Fax:
- Phone: 912-267-6270
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 24744 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0500X |
| Taxonomy | Preventive Medicine/Occupational Environmental Medicine Physician |
| License Number | 24744 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: