Individual
JOSE BENJAMIN RUIZ-LAGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 NORTHSIDE CHEROKEE BLVD, CANTON, GA 30115-8015
(770) 224-1000
(770) 224-2451
Mailing address
201 HOSPITAL RD, CANTON, GA 30114-2408
(770) 720-5100
(404) 851-6325
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
063948
GA
208M00000X
Hospitalist Physician
Primary
063948
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11934114
CAQH
—
05
—
1740470749
—
NV
05
—
705366756A
—
GA
Enumeration date
07/26/2007
Last updated
03/12/2018
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