Organization
LAFAYETTE SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAKIA M OGLESBY MD (SOLE OWNER)
(706) 610-4856
Entity
Organization
Contact information
Practice address
1015 LAFAYETTE PKWY, LAGRANGE, GA 30241
(762) 323-1260
(762) 323-1275
Mailing address
1015 LAFAYETTE PKWY, LAGRANGE, GA 30241
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
05/23/2022
Last updated
06/30/2023
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