Provider Demographics
NPI:1578766176
Name:INTERNAL MEDICINE ASSOCIATES OF DALTON INC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES OF DALTON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:706-226-5300
Mailing Address - Street 1:1209 W WALNUT AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-3961
Mailing Address - Country:US
Mailing Address - Phone:706-226-5300
Mailing Address - Fax:706-226-6277
Practice Address - Street 1:1209 W WALNUT AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3961
Practice Address - Country:US
Practice Address - Phone:706-226-5300
Practice Address - Fax:706-226-6277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-09
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA48336207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty