Organization
RENAL ASSOCIATES OF LAGRANGE AT EMORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY REYNOLDS (OFFICE MANAGER)
(706) 322-1486
Entity
Organization
Contact information
Practice address
1300 LAFAYETTE PKWY STE D, LAGRANGE, GA 30241-2610
(706) 882-2800
(706) 324-3419
Mailing address
6228 BRADLEY PARK DR STE A, COLUMBUS, GA 31904-3605
(706) 322-1486
(706) 324-3419
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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