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Individual

EARL S GOLIGHTLY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
681 SOUTH 9TH STREET, GRIFFIN, GA 30224
(770) 228-5745
(770) 228-5317
Mailing address
681 SOUTH 9TH STREET, GRIFFIN, GA 30224
(770) 228-5745
(770) 228-5317

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
22148
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00444034A
GA
01
22148
STATE LICENSE
GA
Enumeration date
06/06/2006
Last updated
07/08/2007
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