Organization
JACEK LYSZKOWICZ MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACEK EUSTACHY LYSZKOWICZ MD (OWNER)
(770) 922-9622
Entity
Organization
Contact information
Practice address
1366 WELLBROOK CIR NE, SUITE B, CONYERS, GA 30012-3872
(770) 922-9622
(770) 922-9620
Mailing address
1366 WELLBROOK CIR NE, SUITE B, CONYERS, GA 30012-3872
(770) 922-9622
(770) 922-9620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
047113
GA
Other
Enumeration date
05/20/2006
Last updated
04/24/2008
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