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Individual

DR. CHARLES COY LASSITER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 TOWER RD NE, SUITE 200, MARIETTA, GA 30060-9411
(770) 514-7550
(770) 514-1390
Mailing address
400 TOWER RD NE, SUITE 200, MARIETTA, GA 30060-9411
(770) 514-7550
(770) 514-1390

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
052984
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
052984
GA
207RP1001X
Pulmonary Disease Physician
Primary
052984
GA

Other

Enumeration date
06/27/2006
Last updated
01/14/2016
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