Organization
TEMPLE MEDICAL LLC
Active
Other names
TempleMed Health
Organization subpart
No
Provider details
NPI number
Authorized official
LORI A HUDSON (OWNER PROVIDER)
(770) 462-1170
Entity
Organization
Contact information
Practice address
503 MAIN ST, VILLA RICA, GA 30180-1931
(770) 462-1170
(770) 462-1174
Mailing address
503 MAIN ST, VILLA RICA, GA 30180-1931
(805) 869-3240
(770) 462-1174
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RN101917-NP
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000805153C
—
GA
Enumeration date
04/18/2007
Last updated
08/15/2019
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