=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821483488
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALLAWY ALLAWY
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2015
-----------------------------------------------------
Last Update Date | 07/29/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2300 MANCHESTER EXPY STE A201
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31904-6856
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-320-2766
-----------------------------------------------------
Fax | 706-320-2768
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2300 MANCHESTER EXPY STE 2001A
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31904-6802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-320-3126
-----------------------------------------------------
Fax | 706-320-3054
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | 86914
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------