Healthcare Provider Details

I. General information

NPI: 1962763441
Provider Name (Legal Business Name): EDGAR JOSEPH DOLLAR II D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOEY DOLLAR D.O.

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 02/25/2021
Certification Date: 02/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 N CENTER ST
THOMASTON GA
30286-3695
US

IV. Provider business mailing address

PO BOX 370
FORTSON GA
31808-0370
US

V. Phone/Fax

Practice location:
  • Phone: 706-646-4371
  • Fax: 706-646-4372
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number70879
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: