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196 Ridgecrest Cir Clayton GA 30525-4111 | |
(706) 782-4233 | |
Not Available |
Full Name | |
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Speciality | Internal Medicine - Gastroenterology |
Location | 196 Ridgecrest Cir, Clayton, Georgia |
Authorized Official Name and Position | Vicki F Lawrenson (COO) |
Authorized Official Contact | 3343860343 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 5013 Montgomery AL 36103-5013 Ph: (334) 386-0343 | 196 Ridgecrest Cir Clayton GA 30525-4111 Ph: (706) 782-4233 |
NPI Number | 1962764308 |
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Provider Enumeration Date | 06/12/2012 |
Last Update Date | 06/12/2012 |
Identifier | Type | State | Issuer |
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1962764308 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
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