Individual
JOHN WILLIAM CARL CARTER MALLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1075 LAFAYETTE PKWY STE 100, LAGRANGE, GA 30241-3507
(706) 443-5273
(706) 443-5275
Mailing address
1075 LAFAYETTE PKWY STE 100, LAGRANGE, GA 30241-3507
(706) 443-5273
(706) 443-5275
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
95070
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
95070
GA
Other
Enumeration date
03/19/2018
Last updated
08/07/2025
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