Provider Demographics
NPI:1396922530
Name:WILLIAM G. IRWIN, M.D. P.A.
Entity type:Organization
Organization Name:WILLIAM G. IRWIN, M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:H
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-328-1433
Mailing Address - Street 1:218 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-4102
Mailing Address - Country:US
Mailing Address - Phone:478-328-1433
Mailing Address - Fax:478-922-7939
Practice Address - Street 1:212 HOSPITAL DR
Practice Address - Street 2:STE H
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-4207
Practice Address - Country:US
Practice Address - Phone:478-328-1433
Practice Address - Fax:478-922-7939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA012172207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty