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Individual

RONALD LINDQUIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
112 MIMOSA DR, THOMASVILLE, GA 31792-6605
(229) 227-0045
(229) 227-9120
Mailing address
112 MIMOSA DR, THOMASVILLE, GA 31792-6605
(229) 227-0045
(229) 227-9120

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003926
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100002377B
GA
01
11DO266342
CLIA LAB NUMBER
GA
01
GRP1474
MEDICARE GROUP NUMBER
GA
Enumeration date
10/26/2006
Last updated
11/12/2015
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