Individual
LAUREN ALENE BEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3193 E 1ST ST, VIDALIA, GA 30474-8830
(912) 537-8588
Mailing address
197 AUSTIN WAY, VIDALIA, GA 30474-5064
(912) 347-4471
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12351
GA
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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