Individual
DIANE L MCGOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
CLARK-HOLDER CLINIC, P.A., 303 SMITH STREET, LAGRANGE, GA 30240
(706) 882-8831
(706) 812-4091
Mailing address
CLARK-HOLDER CLINIC, P.A., 303 SMITH STREET, LAGRANGE, GA 30240
(706) 882-8831
(706) 812-4091
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
29049
GA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
29040
GA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
29049
GA
Other
Enumeration date
06/23/2006
Last updated
09/11/2025
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