Organization
LAGRANGE PRIMARY CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VISHWAS KADAM M.D. (OWNER)
(678) 923-9486
Entity
Organization
Contact information
Practice address
505 JENKINS ST, LAGRANGE, GA 30240-4225
(678) 923-9486
(678) 401-0292
Mailing address
25 TURNBERRY CIR, NEWNAN, GA 30265-4154
(678) 923-9486
(678) 401-0292
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
062529
GA
Other
Enumeration date
03/04/2013
Last updated
06/25/2013
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