Organization
SOUTHWESTERN PATHOLOGY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID E. MARTIN M.D. (PRESIDENT)
(706) 596-4100
Entity
Organization
Contact information
Practice address
2122 MANCHESTER EXPY, ST. FRANCIS HOSPITAL LABORATORY, COLUMBUS, GA 31904-6878
(706) 596-4100
Mailing address
102 WOODCHASE, LAGRANGE, GA 30240-9734
(706) 845-3175
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI9362
RAILROAD MEDICARE
GA
Enumeration date
02/24/2006
Last updated
11/14/2007
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