Individual
DR. LAWRENCE F BRACK III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5900 HILLANDALE DR, SUITE 345, LITHONIA, GA 30058-3802
(770) 987-0733
(770) 987-3978
Mailing address
5900 HILLANDALE DR, SUITE 345, LITHONIA, GA 30058-3802
(770) 987-0733
(770) 987-3978
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
047403
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000898422C
—
GA
Enumeration date
08/07/2006
Last updated
06/13/2014
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