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Individual

DR. KELLIE V LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
818 SAINT SEBASTIAN WAY, SUITE 311, AUGUSTA, GA 30901-2651
(706) 724-3473
Mailing address
4354 DEERWOOD LN, EVANS, GA 30809-4604
(706) 210-1449

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
043233
GA

Other

Enumeration date
06/12/2006
Last updated
11/06/2013
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