Organization
LIFEBOAT MEDICAL ASSOCIATES 2, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELLEY DEPP (PAYER RELATIONS LIAISON)
(770) 579-2626
Entity
Organization
Contact information
Practice address
1201 GEORGIAN PARK, PEACHTREE CITY, GA 30269-6972
(770) 631-4873
(770) 631-0684
Mailing address
PO BOX 468329, ATLANTA, GA 31146-8329
(404) 943-0205
(404) 943-0209
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Enumeration date
12/15/2017
Last updated
12/15/2017
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