Individual
MR. JACK LEE SORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 WELL BROOK CIRCLE, CONYERS, GA 30012-3873
(770) 922-3023
(770) 929-1016
Mailing address
1301 WELLBROOK CIRCLE NE, CONYERS, GA 30012-3873
(770) 922-3023
(770) 929-1016
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
016434
GA
Other
Enumeration date
10/04/2006
Last updated
01/29/2014
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