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Organization

RAYMOND L. STOVALL, M.D., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RAYMOND L STOVALL M.D. (OWNER)
(678) 376-1800
Entity
Organization

Contact information

Practice address
600 PROFESSIONAL DR, SUITE 150, LAWRENCEVILLE, GA 30045-7651
(678) 376-1800
(678) 376-5500
Mailing address
600 PROFESSIONAL DR, SUITE 150, LAWRENCEVILLE, GA 30045-7651
(678) 376-1800
(678) 376-5500

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
025291
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00282675B
GA
01
10659984294
HUMANA
GA
01
182686
COVENTRY
GA
01
254743708
HUMANA GOLD
GA
01
4031478
AETNA
GA
01
52450038
BLUE CROSS
GA
Enumeration date
08/09/2006
Last updated
06/18/2008
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