Waters, Gary Douglas
Waters, Gary Douglas is an individual health care provider with primary practice located at 2424 Double Churches Rd , Columbus GA 31909-2741. He recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as his primary health care specialty. Waters, Gary Douglas can be contacted via phone (706) 324-6112.Contact Information
Primary practice address
2424 Double Churches Rd
Columbus GA 31909-2741
Phone: (706) 324-6112
Fax: (706) 596-8259
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SLP000655 | Georgia |
Profile Details
| NPI number | 1992868863 |
|---|---|
| LBN Legal business name | Waters, Gary Douglas |
| Credentials | MSC, CCC-S |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 19th, 2006 |
| Last updated | Aug 29th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992868863 | NPPES |
| Georgia | Other | 52164429 | BCBS OF GA PROVIDER NUMBE |
| Georgia | MEDICAID | 308298384A | BCBS OF GA PROVIDER NUMBE |
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