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General NPI Number Information
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NPI Number | 1578766176
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE ASSOCIATES OF DALTON INC
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Dates
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Enumeration Date | 06/09/2007
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Last Update Date | 01/25/2010
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Provider Practice Location Address
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Address Line | 1209 W WALNUT AVE SUITE 6
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City | DALTON
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State | GA
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Zip | 30720-3961
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Country | US
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Telephone | 706-226-5300
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Fax | 706-226-6277
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Provider Business Mailing Address
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Address Line | 1209 W WALNUT AVE SUITE 6
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City | DALTON
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State | GA
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Zip | 30720-3961
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Country | US
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Telephone | 706-226-5300
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Fax | 706-226-6277
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Authorized Official
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Title or Position | CEO
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Name | DR. DAVID STEPHEN CARSON SR.
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Credential | M.D.
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Telephone | 706-226-5300
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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 | 48336
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License Number State | GA
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