Organization
HENRY A MAGNANT MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINA DIAZ (INSURANCE SPECIALIST)
(770) 995-0226
Entity
Organization
Contact information
Practice address
911 DULUTH HWY, STE D7, LAWRENCEVILLE, GA 30043-5320
(770) 995-0226
(770) 995-0227
Mailing address
911 DULUTH HWY, STE D7, LAWRENCEVILLE, GA 30043-5320
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
GA19072
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP4651
MEDICARE GROUP
GA
Enumeration date
10/04/2007
Last updated
10/04/2007
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