Individual provider · NPI-1
Jonathan S Dial, P.A.
Physician Assistant, Medical · Waycross, GA
NPI number1366523292
StatusActive
Last updated in NPPESJul 30, 2026
Details
- NPI
- 1366523292
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jonathan S Dial
- Credential
- P.A.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 18, 2006
- Certification date
- Jul 30, 2026
- Last updated
- Jul 30, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 004822 | GA | Yes |
Practice location
808 Beacon StWaycross, GA 31501-7104
Phone 912-490-4325 · Fax 912-490-2873
Mailing address
808 Beacon StWaycross, GA 31501-7104
Phone 912-490-4325 · Fax 912-490-2873
Other practice locations
1900 Tebeau St
Waycross, GA 31501-6357
Waycross, GA 31501-6357
Phone 912-338-6368 · Fax 912-338-7113
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