| Lost Mountain Internal Medicine, Llc | |
|
5041 Dallas Hwy Bldg 1, Suite H Powder Springs GA 30127-6458 | |
| (770) 874-0692 | |
| (770) 874-0696 |
| Full Name | Lost Mountain Internal Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5041 Dallas Hwy, Powder Springs, Georgia |
| Authorized Official Name and Position | Alacia Tarpley (MEMBER) |
| Authorized Official Contact | 7708740692 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lost Mountain Internal Medicine, Llc 5041 Dallas Hwy Bldg 1, Suite H Powder Springs GA 30127-6458 Ph: (770) 874-0692 | Lost Mountain Internal Medicine, Llc 5041 Dallas Hwy Bldg 1, Suite H Powder Springs GA 30127-6458 Ph: (770) 874-0692 |
| NPI Number | 1578736286 |
|---|---|
| Provider Enumeration Date | 04/03/2008 |
| Last Update Date | 04/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578736286 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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