| Lagrange Neurology Corporation | |
|
300 Medical Dr Suite 701 Lagrange GA 30240-4130 | |
| (706) 882-0552 | |
| (706) 882-0599 |
| Full Name | Lagrange Neurology Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 300 Medical Dr, Lagrange, Georgia |
| Authorized Official Name and Position | Paige Bass Hunt (OFFICE MANAGER) |
| Authorized Official Contact | 7068820552 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lagrange Neurology Corporation 300 Medical Dr Suite 701 Lagrange GA 30240-4130 Ph: (706) 882-0552 | Lagrange Neurology Corporation 300 Medical Dr Suite 701 Lagrange GA 30240-4130 Ph: (706) 882-0552 |
| NPI Number | 1932409224 |
|---|---|
| Provider Enumeration Date | 11/02/2010 |
| Last Update Date | 03/26/2020 |
| Certification Date | 03/26/2020 |
| Medicare PECOS PAC ID | 1052591013 |
|---|---|
| Medicare Enrollment ID | O20110208000491 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932409224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
| Provider Name | Peter Ping Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205828993 PECOS PAC ID: 4981507845 Enrollment ID: I20050106000374 |
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