| Georgia Stars Medical Clinic, Llc | |
|
142 Old Mill Rd Lagrange GA 30241-6704 | |
| (706) 885-1900 | |
| (706) 882-1350 |
| Full Name | Georgia Stars Medical Clinic, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 142 Old Mill Rd, Lagrange, Georgia |
| Authorized Official Name and Position | Quoc Vinh Ngo (OWNER) |
| Authorized Official Contact | 7068851900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgia Stars Medical Clinic, Llc 142 Old Mill Rd Lagrange GA 30241-6704 Ph: (706) 885-1900 | Georgia Stars Medical Clinic, Llc 142 Old Mill Rd Lagrange GA 30241-6704 Ph: (706) 885-1900 |
| NPI Number | 1255989794 |
|---|---|
| Provider Enumeration Date | 08/28/2019 |
| Last Update Date | 08/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255989794 | NPI | - | NPPES |
| 80387 | Other | GA | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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