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Organization
EAST GEORGIA REGIONAL MEDICAL CENTER, LLC
Active
Organization
EAST GEORGIA REGIONAL MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA LALOR (DIRECTOR)
(615) 925-4565
Entity
Organization
Contact information
Practice address
1497 FAIR RD, SUITE 206, STATESBORO, GA 30458-0822
(912) 871-5437
Mailing address
1497 FAIR RD, SUITE 206, STATESBORO, GA 30458-0822
(912) 871-5437
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
249619966A
—
GA
Enumeration date
07/26/2006
Last updated
12/18/2017
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