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Individual

DR. JIM WAYNE LATIMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
101 REGENCY PARK DR, SUITE 150, MCDONOUGH, GA 30253-7080
(770) 957-4195
(770) 898-6337
Mailing address
101 REGENCY PARK DR, SUITE 150, MCDONOUGH, GA 30253-7080
(770) 957-4195
(770) 898-6337

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
039391
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
039391
STATE LICENSE
GA
Enumeration date
12/05/2006
Last updated
10/13/2014
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