Individual
HARRY S. LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
902 N 7TH ST, CORDELE, GA 31015-3234
(229) 276-3342
Mailing address
PO BOX 568, CORDELE, GA 31010-0568
(229) 273-4956
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
032934
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000532111B
—
GA
01
—
220009977
RAILROAD MEDICARE
GA
Enumeration date
06/06/2007
Last updated
01/30/2012
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