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Organization
MAGNOLIA MEDICAL GROUP, LLC
Active
Organization
MAGNOLIA MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN LANCE (DOCTOR/OWNER)
(478) 453-2341
Entity
Organization
Contact information
Practice address
946 HARMONY RD, EATONTON, GA 31024-5877
(706) 991-5320
(866) 720-5313
Mailing address
946 HARMONY RD STE B, EATONTON, GA 31024-5877
(706) 991-5320
(866) 720-5313
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
ME53031
GA
Other
Enumeration date
08/08/2016
Last updated
09/19/2024
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