Individual
GEORGE HAWORTH LATTA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 W MINERAL KING AVE, VISALIA, CA 93291-6237
(800) 717-5670
(866) 757-9283
Mailing address
PO BOX 7346, VISALIA, CA 93290-7346
(800) 717-5670
(866) 757-9283
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
050705
CA
2080N0001X
Neonatal-Perinatal Medicine Physician
30834141205
UT
2080N0001X
Neonatal-Perinatal Medicine Physician
MD0000020432
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01319250
—
CO
05
—
309910
—
TN
Enumeration date
12/11/2006
Last updated
09/08/2010
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