Individual
DR. PATRICIA HARTLAGE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4301 UNIVERSITY PKWY, EVANS, GA 30809-3089
(706) 854-2534
(706) 854-2559
Mailing address
PO BOX 1758, EVANS, GA 30809-1758
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
014815
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00013835G
—
GA
Enumeration date
06/13/2005
Last updated
07/08/2007
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