MEDICARE: MS. RHONWYNN GENNENE DOZIER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	004492	GA

General Provider Information

NPI Number	:	1780771410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RHONWYNN GENNENE DOZIER PA-C

Provider Business Mailing Address
First Line	:	1835 SAVOY DR STE 300
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30341-1071
Country	:	US
Telephone Number	:	770-228-1767
Fax Number	:	770-228-7562

Provider Business Practice Location Address
First Line	:	747 S 8TH ST STE C
Second Line	:
City	:	GRIFFIN
State	:	GA
Zip	:	30224-4884
Country	:	US
Telephone Number	:	770-228-1767
Fax Number	:	770-228-7562

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	11/23/2020

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