Organization
SURGICAL CLINIC OF GRIFFIN-SPALDING, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM DOUGLAS LAZENBY JR. M.D. (PRESIDENT)
(770) 233-1080
Entity
Organization
Contact information
Practice address
220 W COLLEGE ST STE B, GRIFFIN, GA 30224-4250
(770) 233-1080
(770) 233-3680
Mailing address
220 W COLLEGE ST STE B, GRIFFIN, GA 30224-4250
(770) 233-1080
(770) 233-3680
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202G705872
MEDICARE PTAN
GA
Enumeration date
01/22/2010
Last updated
06/23/2010
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