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General NPI Number Information
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NPI Number | 1306959754
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Entity Type | Individual
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Provider Name | WAYNE DWIGHT AUSTIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 07/13/2011
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Provider Practice Location Address
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Address Line | 260 N BROAD ST
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City | WINDER
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State | GA
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Zip | 30680-2180
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Country | US
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Telephone | 770-867-9800
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Fax | 770-868-4569
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Provider Business Mailing Address
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Address Line | PO BOX 1761 260 NORTH BROAD STREET
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City | WINDER
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State | GA
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Zip | 30680-6761
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Country | US
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Telephone | 770-867-9800
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Fax | 770-868-4569
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 207R00000X
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License Number State | GA
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