Provider Demographics
NPI:1124332804
Name:RAHHAL GASTROENTEROLOGY ASSOCIATES, PC
Entity type:Organization
Organization Name:RAHHAL GASTROENTEROLOGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FADI
Authorized Official - Middle Name:E
Authorized Official - Last Name:RAHHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:229-276-2185
Mailing Address - Street 1:PO BOX 4047
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31208-4047
Mailing Address - Country:US
Mailing Address - Phone:229-276-2185
Mailing Address - Fax:229-276-2186
Practice Address - Street 1:910 N 5TH ST
Practice Address - Street 2:
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015-3254
Practice Address - Country:US
Practice Address - Phone:229-276-2185
Practice Address - Fax:229-276-2186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty