Organization
WEST GEORGIA MULTI SPECIALTY CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LOIS L COPELAND (BILLING CLERK)
(706) 845-0931
Entity
Organization
Contact information
Practice address
106 LUKKEN INDUSTRIAL DR W, LAGRANGE, GA 30240-5912
(706) 882-8128
(706) 883-8638
Mailing address
106 LUKKEN INDUSTRIAL DR W, LAGRANGE, GA 30240-5912
(706) 882-8128
(706) 883-8638
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
014313
GA
Other
Enumeration date
07/19/2007
Last updated
05/15/2012
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