Organization
HGA VILLA RICA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VAUGHN S CLAGETTE MD (PARTNER)
(770) 838-8440
Entity
Organization
Contact information
Practice address
129 BANKHEAD HWY, CARROLLTON, GA 30117-3425
(770) 838-8440
Mailing address
PO BOX 6084, DOUGLASVILLE, GA 30154-0019
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
40639
GA
208M00000X
Hospitalist Physician
40639
GA
Other
Enumeration date
04/27/2017
Last updated
04/27/2017
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