| Jacek Lyszkowicz Md Pc | |
|
1366 Wellbrook Cir Ne Suite B Conyers GA 30012-3872 | |
| (770) 922-9622 | |
| (770) 922-9620 |
| Full Name | Jacek Lyszkowicz Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1366 Wellbrook Cir Ne, Conyers, Georgia |
| Authorized Official Name and Position | Jacek Eustachy Lyszkowicz (OWNER) |
| Authorized Official Contact | 7709229622 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacek Lyszkowicz Md Pc 1366 Wellbrook Cir Ne Suite B Conyers GA 30012-3872 Ph: (770) 922-9622 | Jacek Lyszkowicz Md Pc 1366 Wellbrook Cir Ne Suite B Conyers GA 30012-3872 Ph: (770) 922-9622 |
| NPI Number | 1598719007 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 04/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598719007 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 047113 (Georgia) | Primary |
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