Individual
LAVERNE RICHFORD KEIZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1035 RED BUD RD NE, CALHOUN, GA 30701-6008
(706) 879-4776
(706) 879-5841
Mailing address
PO BOX 12938, C/O CLINIC MANAGEMENT, CALHOUN, GA 30703-0128
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
038825
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000632343H
—
GA
05
—
000632343J
—
GA
Enumeration date
07/02/2006
Last updated
12/17/2018
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