Individual
DR. EDWIN LEE HIATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2841 N PATTERSON ST, VALDOSTA, GA 31602-1743
(229) 293-0132
(229) 293-0162
Mailing address
511 W COTTON AVE, LAKE PARK, GA 31636-6601
(229) 559-7611
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
12920
GA
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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