Organization
LIFEBOAT MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA A O'HERON M.D. (OWNER)
(770) 631-4873
Entity
Organization
Contact information
Practice address
1201 GEORGIAN PARK, PEACHTREE CITY, GA 30269-6972
(770) 631-4873
(770) 631-0684
Mailing address
1201 GEORGIAN PARK, PEACHTREE CITY, GA 30269-1201
(770) 631-4873
(770) 631-0684
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437163946
NPI
GA
Enumeration date
05/24/2007
Last updated
02/21/2008
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