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Organization
CENTRAL GEORGIA ADRENAL AND REPRODUCTIVE ENDOCRINOLOGY
Active
Organization
CENTRAL GEORGIA ADRENAL AND REPRODUCTIVE ENDOCRINOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANSEL MARK RAYNER PA-C (OWNER)
(470) 317-3855
Entity
Organization
Contact information
Practice address
374 RACETRACK RD, MCDONOUGH, GA 30252-1022
(801) 657-8137
(801) 657-8137
Mailing address
121 LIGHTHORSE BLVD, MCDONOUGH, GA 30252-2998
(801) 657-8137
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
261QA0006X
Ambulatory Fertility Facility
—
NULL
Other
Enumeration date
01/24/2025
Last updated
01/24/2025
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