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General NPI Number Information
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NPI Number | 1124332804
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Entity Type | Organization
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Legal Business Name | RAHHAL GASTROENTEROLOGY ASSOCIATES, PC
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 08/04/2010
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Provider Practice Location Address
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Address Line | 910 N 5TH ST
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City | CORDELE
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State | GA
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Zip | 31015-3254
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Country | US
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Telephone | 229-276-2185
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Fax | 229-276-2186
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Provider Business Mailing Address
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Address Line | PO BOX 4047
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City | MACON
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State | GA
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Zip | 31208-4047
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Country | US
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Telephone | 229-276-2185
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Fax | 229-276-2186
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Authorized Official
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Title or Position | MD / OWNER
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Name | FADI E RAHHAL
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Credential | M.D.
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Telephone | 229-276-2185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State | GA
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