Individual
GEORGIA LYDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-0100
(843) 792-3780
Mailing address
171 ASHLEY AVE, CHARLESTON, SC 29425-0100
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
LL90210
SC
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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