Organization
LAFAYETTE MEDICAL PROVIDERS
Active
Other names
Mainstreet Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA ANN BALLINGER (OFFICE MANAGER)
(706) 638-1506
Entity
Organization
Contact information
Practice address
1201B N MAIN ST, LA FAYETTE, GA 30728-2150
(706) 638-1506
(706) 638-1507
Mailing address
1201B N MAIN ST, LA FAYETTE, GA 30728-2150
(706) 638-1506
(706) 638-1507
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/07/2006
Last updated
08/22/2020
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