Individual
MISS SAMMIE LEAN LUMPKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
3621 POINTE CT, FAIRBURN, GA 30213-6001
(770) 774-0406
Mailing address
3621 POINTE CT, FAIRBURN, GA 30213
(770) 774-0406
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3028
CSA
GA
Enumeration date
06/12/2007
Last updated
07/08/2007
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