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Dr. Charles Wayne Dodgen, M.D.

Family Medicine in Thomaston, GA. Individual provider (NPI-1).

NPI number1104846625
StatusActive
Last updated in NPPESMar 30, 2016

Details

NPI
1104846625
Entity type
Individual (NPI-1)
Name
Dr. Charles Wayne Dodgen
Credential
M.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
Jul 20, 2006
Last updated
Mar 30, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine17100GAYes

Practice location

107 Jackson Ave
Suite A
Thomaston, GA 30286-3433

Phone 706-647-8101 · Fax 706-647-8543

Mailing address

107 Jackson Ave
Suite A
Thomaston, GA 30286-3433

Phone 706-647-8101 · Fax 706-647-8543

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