Organization
RAYMOND L. STOVALL, M.D., P.C.
Active
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
Update your record
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