Wing, Dale
Wing, Dale is an individual health care provider with primary practice located at 2621 E Pinetree Blvd , Thomasville GA 31792-4840. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wing, Dale can be contacted via phone (229) 584-4100.Contact Information
Primary practice address
2621 E Pinetree Blvd
Thomasville GA 31792-4840
Phone: (229) 584-4100
Fax: (229) 584-5955
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 15430 | Mississippi |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 068022 | Georgia |
Profile Details
| NPI number | 1720045552 |
|---|---|
| LBN Legal business name | Wing, Dale |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2006 |
| Last updated | Aug 5th, 2020 - about 6 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 | 1720045552 | NPPES |
| Mississippi | MEDICAID | 00122485 |
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