Individual
EDWARD C LAUTERBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
940 HWY 96, WARNER ROBINS, GA 31088
(478) 988-1222
(478) 988-1106
Mailing address
1550 COLLEGE STREET, MACON, GA 31207-1554
(478) 301-4111
(478) 301-2387
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
031056
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000383908A
—
GA
01
—
260022713
RAILROAD MEDICARE
GA
Enumeration date
10/31/2006
Last updated
12/12/2011
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