| Organization Name: | DODGE EMERGENCY GROUP LLC |
| NPI Number: | 1164481065 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM SCHUMACHER (CEO) |
| Mailing Address: | 715 Griffin Ave Eastman |
| State: | GA US |
| Postal Code: | 310236716 |
| Phone Number: | 4783744000 |
| Fax Number: | |
| NPI Enumeration Date: | 03/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |