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Individual
GEORGE LYCURGLUS PETTY
Active
Individual
GEORGE LYCURGLUS PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
24118
MS
207QA0505X
Adult Medicine Physician
Primary
MD.34536
AL
Other
Enumeration date
05/24/2013
Last updated
08/24/2018
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